Increased survival, limb preservation, and prognostic factors for osteosarcoma

Increased survival, limb preservation, and prognostic factors for osteosarcoma

Author Petrilli, Antonio Sergio Autor UNIFESP Google Scholar
Gentil, Fernando C. Google Scholar
Epelman, Sidnei Google Scholar
Lopes, Luiz Fernando Google Scholar
Bianchi, Alois Google Scholar
Lopes, Ademar Google Scholar
Figueiredo, Marco Tulio de Assis Google Scholar
Marques, Elvira Google Scholar
Bellis, Normando de Google Scholar
Consentino, Elio Google Scholar
Prospero, Donato Google Scholar
Camargo, Olavo Pires de Google Scholar
Oliveira, Nanni R. Google Scholar
Franco, Eduardo Google Scholar
Jaffe, Norman Google Scholar
Universidade de São Paulo (USP)
São Paulo HOSP
Universidade Federal de São Paulo (UNIFESP)
Abstract Preoperative intraarterial (IA) cisplatin (CDP) was administered to 92 patients with nonmetastatic osteosarcoma. the ages of the patients ranged from 4 to 28 years. Sixty-four patients (70%) received 2 or 3 preoperative courses and 28 (30%) received 4 or more. Sixty-two specimens were available for pathologic examination to assess the degree of tumor necrosis. More than 90% tumor destruction was observed in 16 of 42 patients (38%) who received 1 to 3 preoperative courses as opposed to 17 of 20 (85%) who received 4 or more courses. Patients who received 4 or more courses had a 2-fold probability of achieving more than 90% tumor necrosis, and 68% underwent conservative surgery. of those who received 3 or less courses, 23% underwent conservative surgery. Postoperatively, patients were treated with intravenous (IV) CDP alternating with doxorubicin (ADR) (Adriamycin, Dria Laboratories, Columbus, OH). Pulmonary metastases developed in 36 patients, bone metastases in 2, and local recurrence in 6. Two patients died of cardiac failure without evidence of disease. Thus, 46 patients (50%) were continuously free of disease 18 to 78 months after diagnosis. Univariate and multivariate analyses showed that male sex, low grade preoperative chemotherapy-induced necrosis, and nonosteoblastic histologic condition were prognostic factors predictive of recurrence, while male sex and large tumor size were prognostic factors predictive of death. These results are comparable with those reported by other centers and are superior to our previous experiences that yielded survival rates of 5% to 10%. A substantial number of patients also had the opportunity to achieve tumor removal with conservative surgery.
Language English
Date 1991-08-15
Published in Cancer. New York: Wiley-liss, v. 68, n. 4, p. 733-737, 1991.
ISSN 0008-543X (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 733-737
Access rights Open access Open Access
Type Article
Web of Science ID WOS:A1991FY94700011

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