Picci, J Clin Oncol 1994 - Relationship of Chemotherapy-Induced Necrosis and Surgical Margins to Local Recurrence in Osteosarcoma

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Relationship of Chemotherapy-Induced Necrosis and Surgical Margins to Local Recurrence in Osteosarcoma

Picci, Campanacci, et al.·J Clin Oncol·1994·304 citations·Retrospective cohort

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Purpose and Methods

To assess patients with high-grade osteosarcoma treated at our institution for various prognostic factors for the development of local recurrence of disease. Follow-up data were available for all patients and the mean follow-up duration was 65 months in surviving patients.

Results

There were 28 local recurrences in this study (7%).
Of these, only three patients (11%) were alive at the most recent follow-up point, 28, 53, and 54 months after local recurrence.
None of 59 patients who were treated primarily with a radical amputation and none of 10 who underwent a rotationplasty developed local recurrence.
Four of 48 patients (8%) who had wide amputations, one of whom had an intralesional amputation, and 23 of 237 (10%) who had limb-salvage surgery developed locally recurrent disease.
Of 237 patients who underwent limb-sparing resection, three prognostic factors for local control were identified.
The strongest association with local recurrence was chemotherapy response (P < .0001), followed closely by surgical margins (P = .0001).
Older patients were more likely to have locally recurrent disease (P = .033), with each decade of life older than the first decade having a relative risk of 1.5 times greater per decade (SE = 0.16; 95% confidence interval, 0.034 to .0650).
Factors that were not associated with local recurrence included sex, date of diagnosis, and anatomic site of disease.

Conclusions

Chemotherapy-induced tumor necrosis and surgical margins are important prognostic factors for local control of patients with osteosarcoma.

Copyright remains with the authors and publisher.

Relationship of Chemotherapy-Induced Necrosis and Surgical Margins to Local Recurrence in Osteosarcoma.

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Relationship of Chemotherapy-Induced Necrosis and Surgical Margins to Local Recurrence in Osteosarcoma

Picci, Campanacci, et al.·J Clin Oncol·1994·304 citations·Retrospective cohort

|

Purpose and Methods

To assess patients with high-grade osteosarcoma treated at our institution for various prognostic factors for the development of local recurrence of disease. Follow-up data were available for all patients and the mean follow-up duration was 65 months in surviving patients.

Results

There were 28 local recurrences in this study (7%).
Of these, only three patients (11%) were alive at the most recent follow-up point, 28, 53, and 54 months after local recurrence.
None of 59 patients who were treated primarily with a radical amputation and none of 10 who underwent a rotationplasty developed local recurrence.
Four of 48 patients (8%) who had wide amputations, one of whom had an intralesional amputation, and 23 of 237 (10%) who had limb-salvage surgery developed locally recurrent disease.
Of 237 patients who underwent limb-sparing resection, three prognostic factors for local control were identified.
The strongest association with local recurrence was chemotherapy response (P < .0001), followed closely by surgical margins (P = .0001).
Older patients were more likely to have locally recurrent disease (P = .033), with each decade of life older than the first decade having a relative risk of 1.5 times greater per decade (SE = 0.16; 95% confidence interval, 0.034 to .0650).
Factors that were not associated with local recurrence included sex, date of diagnosis, and anatomic site of disease.

Conclusions

Chemotherapy-induced tumor necrosis and surgical margins are important prognostic factors for local control of patients with osteosarcoma.

Copyright remains with the authors and publisher.

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