Prognostic Analysis Of 47 Patients With Local Recurrent Osteosarcoma

Background:Osteosarcoma(OS)is the most common type of highly malignant bone tumors,mainly affecting children and young adults.The combination of modern chemotherapy and surgical treatment has greatly improved the prognosis of patients with osteosarcoma.But for OS patients with local recurrence,less clinical research about the treatment and prognosis was done.Objective:Based on clinical data of patients with local recurrent osteosarcoma,surgical treatment records and follow-up results,prognostic factors were analyzed,in order to improve the the prognosis of those patients.Methods:From January 2000 to December 2014,the clinical records of 47 patients with local recurrent osteosarcoma were retrospectively analyzed.There were 27 males and 20 females with a median age of 35(8-72 years).The factors of gender,age,tumor location,tissue location,chemotherapy,surgery,operation method,pulmonary metastasis,and extrapulmonary metastases were selected as the measurements for analysis.Kaplan-Meier method was used to calculate the post-recurrence survival of patients with local recurrent osteosarcoma.The univariate analysis of prognosis was performed by log-rank test,and the multivariate analysis of prognosis was performed by COX regression model to select independent factors affecting the prognosis.Results:The median survival time of 47 patients with local recurrent osteosarcoma was 26 months(95%confidence interal,22.3 to 31.4).The univariate analysis of prognosis showed that pulmonary metastasis,extrapulmonary metastases and surgery were significantly associated with the survival rate of patients with local recurrent osteosarcoma.The factors of gender,age,tumor location,tissue location,chemotherapy,and operation method were not associated with the survival rate of those patients.The multivariate analysis of prognosis showed that extrapulmonary metastases,and surgery were the independent factors.But,pulmonary metastasis was not an independent factor affecting the prognosis.Conclusion:Complete resection of tumors and adequate surgical margins can effectively improve the prognosis of patients with local recurrent osteosarcoma.Active measures were performed on patients with both local recurrence and pulmonary metastases.Similarly,active measures should also be performed on patients with both local recurrence and extrapulmonary metastases,to further improve the prognosis and quality of life of those patients.