Bai Guannan, Fu Hao, Zhang Jingyao, Yang Yang, Xu Jingfang, Sun Lidan, Zhang Lin, Chen Wenhao
Department of Orthopedics, Children's Hospital, Zhejiang University School of Medicine, National Children's Regional Medical Center, National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou, 310052, Zhejiang Province, China.
Yunnan Provincial Key Laboratory of Public Health and Biosafety &, School of Public Health, Kunming Medical University, Kunming, 650500, People's Republic of China.
Sci Rep. 2025 Jul 7;15(1):24310. doi: 10.1038/s41598-025-10433-z.
We aimed to compare overall survival (OS) and cancer-specific survival (CSS) between patients with chondroblastic osteosarcoma and fibroblastic osteosarcoma, and to identify prognostic risk factors for these subtypes. Clinical and demographic data from 723 patients with either chondroblastic osteosarcoma or fibroblastic osteosarcoma were extracted from the SEER database. Cox proportional hazards models were used to assess the association of these two types of osteosarcoma with OS, while Fine-Gray competing risk models evaluated CSS, with adjustments for covariates in both unweighted and inverse probability treatment-weighted (IPTW) samples. Subsequent univariate and multivariate analyses identified prognostic factors specific to each subtype. We did not observe any statistically significant differences in terms of the association of the two pathological types of osteosarcomas with OS and CSS using either unweighted or weighted samples. For chondroblastic osteosarcoma, OS was significantly associated with age ≥ 30 years, non-Hispanic Black race, first cancer, primary site, T2-4 stage, M1 stage, and having chemotherapy and surgery were significantly associated with the OS. CSS was associated with age ≥ 30 years, T2-4 stage, M1 stage, and having surgery were associated factors for CSS. In patients with fibroblastic osteosarcoma, OS was significantly associated with primary site, M1 stage, and having radiation and surgery. While CSS was associated with primary site, T2-T4 and TX stage, N1 and M1 stage, and having radiation and surgery. The present study demonstrated the survival profiles of patients with chondroblastic and fibroblastic osteosarcoma. Patients with fibroblastic osteosarcoma do not have better OS or CSS compared with those with chondroblastic osteosarcoma. Multiple risk factors for a poor prognosis were identified, and they can be used to refine the therapeutic approach.
我们旨在比较软骨母细胞性骨肉瘤和纤维母细胞性骨肉瘤患者的总生存期（OS）和癌症特异性生存期（CSS），并确定这些亚型的预后危险因素。从监测、流行病学与最终结果（SEER）数据库中提取了723例软骨母细胞性骨肉瘤或纤维母细胞性骨肉瘤患者的临床和人口统计学数据。采用Cox比例风险模型评估这两种骨肉瘤类型与OS的关联，同时使用Fine-Gray竞争风险模型评估CSS，并在未加权和逆概率处理加权（IPTW）样本中对协变量进行调整。随后的单因素和多因素分析确定了每种亚型特有的预后因素。使用未加权或加权样本，我们未观察到这两种病理类型的骨肉瘤与OS和CSS的关联存在任何统计学上的显著差异。对于软骨母细胞性骨肉瘤，OS与年龄≥30岁、非西班牙裔黑人种族、首发癌症、原发部位、T2 - 4期、M1期显著相关，并且接受化疗和手术与OS显著相关。CSS与年龄≥30岁、T2 - 4期、M1期相关，并且接受手术是CSS的相关因素。在纤维母细胞性骨肉瘤患者中，OS与原发部位、M1期以及接受放疗和手术显著相关。而CSS与原发部位、T2 - T4和TX期、N1和M1期以及接受放疗和手术相关。本研究展示了软骨母细胞性和纤维母细胞性骨肉瘤患者的生存情况。与软骨母细胞性骨肉瘤患者相比，纤维母细胞性骨肉瘤患者的OS或CSS并没有更好。确定了多个预后不良的危险因素，它们可用于优化治疗方案。
