Morsy Ahmed M, Abdelgawad Marwa I, Ahmed Badawy M, Rezk Khalid M, Aboelgheit Amir M, Ramadan Islam K-A, Kamel Hosam E M, Fouad Doaa M, Herdan Rania A, Shabaan Shimaa H, Eltyb Hanan A
Departments of Pediatric Oncology.
Departments of Clinical Oncology and Nuclear Medicine.
J Pediatr Hematol Oncol. 2019 Aug;41(6):e371-e383. doi: 10.1097/MPH.0000000000001407.
To assess the outcome and determine predictors of survival in pediatric patients with osteosarcoma of the extremities treated with a unified chemotherapy protocol at a single institution over a 15-year period.
We performed a retrospective analysis of medical records of 48 pediatric patients with histologically verified osteosarcoma of the extremities diagnosed at South Egypt Cancer Institute and received treatment between January 2001 and December 2015.
With a median follow-up of 61 months for the entire cohort, estimates of overall survival (OS) for 3- and 5-year were 50.9% and 42.1%, respectively. While the estimates of OS for 3- and 5-year in the nonmetastatic group were 79% and 65.2%, respectively. In the multivariable analysis, both metastatic disease at diagnosis and poor response to chemotherapy retained their statistical significance as independent predictors for event-free survival. Whereas for OS, a metastatic disease at diagnosis remained as the lone predictor of a dismal outcome, while a poor response to chemotherapy became marginally associated with an inferior outcome.
In Upper Egypt, whereas slightly less than two thirds of children with localized osteosarcoma of extremities survives their disease, metastasis at presentation remains the key predictor of dismal survival outcomes.
评估在单一机构采用统一化疗方案治疗的15年间儿童肢体骨肉瘤患者的预后并确定生存预测因素。
我们对48例经组织学证实为肢体骨肉瘤的儿童患者的病历进行了回顾性分析,这些患者在南埃及癌症研究所确诊,并于2001年1月至2015年12月期间接受了治疗。
整个队列的中位随访时间为61个月,3年和5年总生存率(OS)估计分别为50.9%和42.1%。非转移组3年和5年OS估计分别为79%和65.2%。在多变量分析中,诊断时的转移性疾病和化疗反应不佳作为无事件生存的独立预测因素仍具有统计学意义。而对于总生存率,诊断时的转移性疾病仍然是预后不良的唯一预测因素,而化疗反应不佳与较差的预后仅有微弱关联。
在上埃及,虽然略少于三分之二的局限性肢体骨肉瘤儿童患者存活下来,但就诊时发生转移仍然是生存预后不良的关键预测因素。