Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Osteosarcoma | Research

Incidence, survival, and associated factors estimation in osteosarcoma patients with lung metastasis: a single-center experience of 11 years in Tianjin, China

Authors: Chao Zhang, Haixiao Wu, Guijun Xu, Yao Xu, Wenjuan Ma, Zhijun Li, Jin Zhang

Published in: BMC Cancer | Issue 1/2023

Login to get access

Abstract

Background

Osteosarcoma is the most common primary malignant bone tumor. The current study was conducted to describe the general condition of patients with primary osteosarcoma in a single cancer center in Tianjin, China and to investigate the associated factors in osteosarcoma patients with lung metastasis.

Methods

From February 2009 to October 2020, patients from Tianjin Medical University Cancer Institute and Hospital, China were retrospectively analyzed. The Kaplan–Meier method was used to evaluate the overall survival of osteosarcoma patients. The Cox proportional hazard regression analysis was performed to analyze the prognostic factors of all osteosarcoma patients and those patients with lung metastasis, respectively. Furthermore, risk factors for developing lung metastasis were identified in synchronous lung metastasis (SLM) and metachronous lung metastasis (MLM) patients.

Results

A total of 203 patients were involved and 150 patients were successfully followed up for survival status. The 5-year survival rate of osteosarcoma was 70.0% and the survival months for patients with SLM and MLM were 33.3 ± 12.6 and 45.8 ± 7.4 months, respectively. The presence of lung metastasis was one of the independent prognostic factors for prognosis of osteosarcoma. In patients with lung metastasis, twenty-one (10.3%) showed lung metastasis at the diagnosis of osteosarcoma and 67 (33%) were diagnosed with lung metastases during the later course. T3 stage (OR = 11.415, 95%CI 1.362–95.677, P = 0.025) and bone metastasis (OR = 6.437, 95%CI 1.69–24.51, P = 0.006) were risk factors of SLM occurrence. Bone metastasis (OR = 1.842, 95%CI 1.053–3.224, P = 0.032), good necrosis (≥ 90%, OR = 0.032, 95%CI 0.050–0.412, P < 0.001), elevated Ki-67 (OR = 2.958, 95%CI 1.098–7.969, P = 0.032) and elevated LDH (OR = 1.791, 95%CI 1.020–3.146, P = 0.043) were proved to be independent risk factors for developing MLM.

Conclusion

The overall survival, prognostic factors and risk factors for lung metastasis in this single center provided insight about osteosarcoma management.
Appendix
Available only for authorised users
Literature
1.
Casali PG, Bielack S, Abecassis N, Aro HT, Bauer S, Biagini R, et al. Bone sarcomas: ESMO-PaedCan-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(Suppl 4):v79-95.CrossRef
2.
Ferrari S, Palmerini E. Adjuvant and neoadjuvant combination chemotherapy for osteogenic sarcoma. Curr Opin Oncol. 2007;19(4):341–6.CrossRefPubMed
3.
Goryń T, Pieńkowski A, Szostakowski B, Zdzienicki M, Ługowska I, Rutkowski P. Functional outcome of surgical treatment of adults with extremity osteosarcoma after megaprosthetic reconstruction-single-center experience. J Orthop Surg Res. 2019;14(1):346.CrossRefPubMedPubMedCentral
4.
Whelan JS, Bielack SS, Marina N, Smeland S, Jovic G, Hook JM, et al. EURAMOS-1, an international randomised study for osteosarcoma: results from pre-randomisation treatment. Ann Oncol. 2015;26(2):407–14.CrossRefPubMed
5.
Smeland S, Bielack SS, Whelan J, Bernstein M, Hogendoorn P, Krailo MD, et al. Survival and prognosis with osteosarcoma: outcomes in more than 2000 patients in the EURAMOS-1 (European and American Osteosarcoma Study) cohort. Eur J Cancer. 2019;109:36–50.CrossRefPubMedPubMedCentral
6.
Goorin AM, Shuster JJ, Baker A, Horowitz ME, Meyer WH, Link MP. Changing pattern of pulmonary metastases with adjuvant chemotherapy in patients with osteosarcoma: results from the multiinstitutional osteosarcoma study. J Clin Oncol. 1991;9(4):600–5.CrossRefPubMed
7.
Ahmed G, Zamzam M, Kamel A, Ahmed S, Salama A, Zaki I, et al. Effect of timing of pulmonary metastasis occurrence on the outcome of metastasectomy in osteosarcoma patients. J Pediatr Surg. 2019;54(4):775–9.CrossRefPubMed
8.
Zhang C, Guo X, Xu Y, Han X, Cai J, Wang X, et al. Lung metastases at the initial diagnosis of high-grade osteosarcoma: prevalence, risk factors and prognostic factors. A large population-based cohort study. Sao Paulo Med J. 2019;137(5):423–9.CrossRefPubMed
9.
Tsoi KM, Lowe M, Tsuda Y, Lex JR, Fujiwara T, Almeer G, et al. How Are Indeterminate Pulmonary Nodules at Diagnosis Associated with Survival in Patients with High-Grade Osteosarcoma? Clin Orthop Relat Res. 2021;479(2):298–308.CrossRefPubMed
10.
Biermann JS, Chow W, Reed DR, Lucas D, Adkins DR, Agulnik M, et al. NCCN Guidelines Insights: Bone Cancer, Version 2.2017. J Natl Compr Canc Netw. 2017;15(2):155–67.CrossRefPubMed
11.
Kusma J, Young C, Yin H, Stanek JR, Yeager N, Aldrink JH. Pulmonary Nodule Size <5 mm Still Warrants Investigation in Patients With Osteosarcoma and Ewing Sarcoma. J Pediatr Hematol Oncol. 2017;39(3):184–7.CrossRefPubMed
12.
Liu F, Zhang Q, Zhou D, Dong J. Effectiveness of (18)F-FDG PET/CT in the diagnosis and staging of osteosarcoma: a meta-analysis of 26 studies. BMC Cancer. 2019;19(1):323.CrossRefPubMedPubMedCentral
13.
Munajat I, Zulmi W, Norazman MZ, Wan FW. Tumour volume and lung metastasis in patients with osteosarcoma. J Orthop Surg (Hong Kong). 2008;16(2):182–5.CrossRefPubMed
14.
Xu G, Wu H, Xu Y, Zhang Y, Lin F, Baklaushev VP, et al. Homogenous and Heterogenous Prognostic Factors for Patients with Bone Sarcoma. Orthop Surg. 2021;13(1):134–44.CrossRefPubMed
15.
Papakonstantinou E, Stamatopoulos A, Athanasiadis ID, Kenanidis E, Potoupnis M, Haidich AB, et al. Limb-salvage surgery offers better five-year survival rate than amputation in patients with limb osteosarcoma treated with neoadjuvant chemotherapy. A systematic review and meta-analysis. J Bone Oncol. 2020;25:100319.CrossRefPubMedPubMedCentral
16.
Kager L, Zoubek A, Pötschger U, Kastner U, Flege S, Kempf-Bielack B, et al. Primary metastatic osteosarcoma: presentation and outcome of patients treated on neoadjuvant Cooperative Osteosarcoma Study Group protocols. J Clin Oncol. 2003;21(10):2011–8.CrossRefPubMed
17.
Lee I, Byun BH, Lim I, Kim BI, Choi CW, Koh JS, et al. Early response monitoring of neoadjuvant chemotherapy using [(18)F]FDG PET can predict the clinical outcome of extremity osteosarcoma. EJNMMI Res. 2020;10(1):1.CrossRefPubMedPubMedCentral
18.
Wu Y, Xu L, Yang P, Lin N, Huang X, Pan W, et al. Survival Prediction in High-grade Osteosarcoma Using Radiomics of Diagnostic Computed Tomography. EBioMedicine. 2018;34:27–34.CrossRefPubMedPubMedCentral
19.
Gok DA, Paksoy TF, Ardic YF, Tokluoglu S, Yazici OK, Demirci A, et al. Outcomes of Adolescent and Adult Patients with Lung Metastatic Osteosarcoma and Comparison of Synchronous and Metachronous Lung Metastatic Groups. PLoS One. 2016;11(5):e152621.
20.
Li W, Zhang S. Survival of patients with primary osteosarcoma and lung metastases. J BUON. 2018;23(5):1500–4.PubMed
21.
22.
Iwata S, Yonemoto T, Iizasa T, Niibe Y, Kamoda H, Ishii T. Oligo-Recurrence of Osteosarcoma Patients: Treatment Strategies for Pulmonary Metastases. Ann Surg Oncol. 2015;22(Suppl 3):S1332–8.CrossRefPubMed
23.
Davis LE, Bolejack V, Ryan CW, Ganjoo KN, Loggers ET, Chawla S, et al. Randomized Double-Blind Phase II Study of Regorafenib in Patients With Metastatic Osteosarcoma. J Clin Oncol. 2019;37(16):1424–31.CrossRefPubMedPubMedCentral
24.
Zheng K, Xu M, Wang L, Yu X. Efficacy and safety of apatinib in advance osteosarcoma with pulmonary metastases: A single-center observational study. Medicine (Baltimore). 2018;97(31):e11734.CrossRefPubMed
25.
Chou AJ, Geller DS, Gorlick R. Therapy for osteosarcoma: where do we go from here? Paediatr Drugs. 2008;10(5):315–27.CrossRefPubMed
26.
Luetke A, Meyers PA, Lewis I, Juergens H. Osteosarcoma treatment - where do we stand? A state of the art review. Cancer Treat Rev. 2014;40(4):523–32.CrossRefPubMed
Metadata
Title
Incidence, survival, and associated factors estimation in osteosarcoma patients with lung metastasis: a single-center experience of 11 years in Tianjin, China
Authors
Chao Zhang
Haixiao Wu
Guijun Xu
Yao Xu
Wenjuan Ma
Zhijun Li
Jin Zhang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-11024-9

Other articles of this Issue 1/2023

BMC Cancer 1/2023 Go to the issue

Study protocol

A multicenter noninferior randomized controlled study of sentinel lymph node biopsy alone versus sentinel lymph node biopsy plus lymphadenectomy for patients with stage I endometrial cancer, INSEC trial concept

Research

Exploring extracellular matrix and prostaglandin pathway alterations across varying resection margin distances of right-sided colonic adenocarcinoma

Research

Identification and clinical validation of key genes as the potential biomarkers in colorectal adenoma

Research

Biliary drainage combined with simultaneous 125I seed strand brachytherapy for the treatment of hilar cholangiocarcinoma

Research

Primary head and neck cancer cell cultures are susceptible to proliferation of Epstein-Barr virus infected lymphocytes

Research

Upregulation of the c-MYC oncogene and adjacent long noncoding RNAs PVT1 and CCAT1 in esophageal squamous cell carcinoma

2024 ASCO Annual Meeting Coverage

Highlights of the Day: Breast cancer – metastatic

Breast Cancer Video

In this session, Dr. Wolff provides his key takeaways from the data presented in the metastatic breast cancer oral abstract session at ASCO 2024.

Watch now

Highlights of the Day: Gynecologic cancer

Gynecologic Cancer Video

Highlights of the Day: Breast Cancer – local/regional/adjuvant

Breast Cancer Video

Neoadjuvant dual immunotherapy improves melanoma outcomes

04-06-2024 Melanoma News

» View more highlights on the ASCO 2024 congress hub page

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits