Petrilli Antonio Sergio, Brunetto Algemir Lunardi, Cypriano Monica Dos Santos, Ferraro Alexandre Archanjo, Donato Macedo Carla Renata Pacheco, Senerchia Andreza Almeida, Almeida Maria Teresa, Costa Cecilia Maria da, Lustosa Daniel, Borsato Maria Luiza, Calheiros Luiz Mario, Barreto Jose Henrique Silva, Epelman Sidnei, Carvalho Eny, Alves Maria Teresa Seixas, Petrilli Marcelo de Toledo, Penna Valter, Pericles Pedro, de Camargo Olavo Pires, Garcia-Filho On Behalf Of The Brazilian Osteosarcoma Treatment Group Reynaldo Jesus
1 Instituto de Oncologia Pediátrica/GRAACC-Universidade Federal de São Paulo , São Paulo, Brazil .
2 Hospital de Clínicas de Porto Alegre , Porto Alegre, Brazil .
J Adolesc Young Adult Oncol. 2013 Dec;2(4):145-52. doi: 10.1089/jayao.2013.0012.
Little information is available regarding the tumor features, prognostic factors, and treatment results in children and adolescents and young adults (AYAs) with osteosarcoma diagnosed in developing countries. We reviewed the results of three observational cohorts of osteosarcoma patients treated in an emerging country.
A total of 604 patients below the age of 30 years with high-grade osteosarcoma were prospectively enrolled in the Brazilian Osteosarcoma Treatment Group (BOTG) studies III, IV, and V. Gender, age, time from onset of symptoms to diagnosis, primary tumor site, presence or absence of metastases at diagnosis, tumor size, type of surgery (limb-sparing or amputation), treatment protocol, and histological response were correlated with survival.
The estimated 5-year overall survival and event-free survival (EFS) rates for the 553 eligible patients were 49% and 39% respectively; of the 390 non-metastatic patients included in the total, overall- and event-free survival were 59% and 48% respectively. Metastases at diagnosis, primary tumor site, type of surgery, and histological response were significant predictors of overall survival and EFS in univariate and multivariate analysis, whereas tumor size and treatment protocol lost prognostic significance in multivariate analysis.
We report on the outcome of three consecutive studies for the treatment of osteosarcoma carried out in Brazil over 15 years. Although the survival rates presented are below those reported in current literature, it represents the result of a favorable experience gathered from the national collaborative work.
关于在发展中国家诊断出骨肉瘤的儿童、青少年和青年（AYAs）的肿瘤特征、预后因素及治疗结果，目前可用信息较少。我们回顾了在一个新兴国家接受治疗的三个骨肉瘤患者观察队列的结果。
共有604名30岁以下的高级别骨肉瘤患者前瞻性纳入巴西骨肉瘤治疗组（BOTG）的研究III、IV和V。性别、年龄、从症状出现到诊断的时间、原发肿瘤部位、诊断时有无转移、肿瘤大小、手术类型（保肢或截肢）、治疗方案及组织学反应与生存率相关。
553名符合条件患者的估计5年总生存率和无事件生存率（EFS）分别为49%和39%；在总计纳入的390名无转移患者中，总生存率和无事件生存率分别为59%和48%。在单因素和多因素分析中，诊断时的转移、原发肿瘤部位、手术类型及组织学反应是总生存率和EFS的显著预测因素，而在多因素分析中肿瘤大小和治疗方案失去了预后意义。
我们报告了巴西在15年里连续开展的三项骨肉瘤治疗研究的结果。尽管所呈现的生存率低于当前文献报道，但它代表了从国家合作工作中积累的良好经验的结果。
