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Tumor necrosis drives prognosis in osteosarcoma: No difference in chemotherapy response and survival between chondroblastic and osteoblastic osteosarcoma. | LitMetric

AI Article Synopsis

  • - The study investigates the impact of tumor necrosis of ≥90% on overall survival (OS) and disease-free survival (DFS) in osteoblastic and chondroblastic osteosarcoma, as well as the influence of the osteosarcoma subtype on these factors.
  • - A retrospective analysis of 156 patients revealed that high tumor necrosis was significantly associated with better survival outcomes for those with osteoblastic osteosarcoma, while chondroblastic osteosarcoma showed a non-significant trend towards improved outcomes.
  • - The findings indicate that the subtype of osteosarcoma does not significantly affect survival rates in patients with good response to chemotherapy (≥90% necrosis), suggesting similar prognostic

Article Abstract

Introduction: The percentage of tumor necrosis is a crucial prognostic factor in osteosarcoma. Many studies adopt a 90 % cutoff based on osteoblastic osteosarcoma, but these findings are generalized to all conventional subtypes, including chondroblastic osteosarcoma. We sought to answer these questions: (1) Is tumor necrosis ≥90 % associated with better overall survival (OS) and disease-free survival (DFS) in osteoblastic and chondroblastic osteosarcoma? (2) Does the osteosarcoma subtype impact tumor necrosis? (3) Does the osteosarcoma subtype in "good" responders (tumor necrosis ≥90 %) affect OS and DFS?.

Materials And Methods: We conducted a retrospective study of 156 patients with osteoblastic and chondroblastic osteosarcoma treated at our institution. All patients received a standardized chemotherapy protocol and underwent surgery with the goal of achieving negative margins (R0 resection). Propensity-score matching was performed to adjust for potential confounders. Kaplan-Meier survival analysis and Cox proportional hazards modeling were performed.

Results: Patients with osteoblastic osteosarcoma and tumor necrosis ≥90 % had higher 5- and 10-year OS and DFS compared to those with necrosis <90 %. In chondroblastic osteosarcoma, a trend towards higher OS and DFS was seen in patients with tumor necrosis ≥90 %; this, however, was not significant. Chondroblastic osteosarcoma was not a risk factor for either tumor necrosis <90 % (p = 0.89) or tumor necrosis <70 % (p = 0.57). Patients with osteoblastic or chondroblastic osteosarcoma that were deemed "good" responders (tumor necrosis ≥90 %) had similar OS and DFS at the 5- and 10-year marks.

Conclusion: Conventional osteosarcoma subtype was not a risk factor for "poor" response. Survival outcomes (OS and DFS) were similar for osteoblastic and chondroblastic osteosarcoma with good response to chemotherapy.

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Source
http://dx.doi.org/10.1016/j.suronc.2024.102155DOI Listing

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