Impact of Surgical Resection and Reasons for Poor Prognosis of Pelvic Osteosarcoma Based on the Bone Tumor Registry in Japan
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Statistical Analyses
3. Results
3.1. Patient and Treatment Demographics for Femoral and Pelvic Osteosarcoma
3.2. Overall Survival of Patients with Femoral and Pelvic Osteosarcoma
3.3. Characteristics of Pelvic Osteosarcoma Patients Treated with or without Surgical Resection
3.3.1. Propensity Score Analysis of Surgical Resection of Pelvic Osteosarcoma
3.3.2. Indication for Surgical Resection of Pelvic Osteosarcoma
4. Discussion
4.1. Reasons for the Poor Prognosis of Pelvic Osteosarcoma Based on the Comparison of Pelvic and Femoral Osteosarcoma
4.2. Impact and Indication of Surgical Resection of Pelvic Osteosarcoma
4.3. Additional/Other Treatment Options
4.4. Future Direction
4.5. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Patient Number (%) | p | ||
---|---|---|---|---|
Femoral OS | Pelvic OS | |||
Gender | Male | 338 (53.5%) | 73 (48.7%) | 0.332 |
Female | 294 (46.5%) | 77 (51.3%) | ||
Metastasis at presentation | M0 | 531 (84.7%) | 109 (73.2%) | 0.001 |
M1 | 96 (15.3%) | 40 (26.8%) | ||
Age | mean | 27.58 years | 50.63 years | <0.001 |
<40 years | 473 (74.8%) | 45 (30.0%) | <0.001 | |
≥40 years | 159 (25.2%) | 105 (70.0%) | ||
<60 years | 542 (80.1%) | 90 (60.0%) | <0.001 | |
≥60 years | 90 (14.2%) | 60 (40.0%) | ||
Size | mean | 10.63 cm | 11.12 cm | 0.278 |
<8 cm | 163 (27.0%) | 32 (21.9%) | 0.247 | |
≥8 cm | 440 (73.0%) | 114 (78.1%) | ||
<12 cm | 408 (67.7%) | 84 (57.5%) | 0.027 | |
≥12 cm | 195 (32.3%) | 62 (42.5%) | ||
Secondary | Primary | 624 (98.7%) | 144 (96.0%) | 0.054 |
Secondary | 8 (1.3%) | 6 (4.0%) | ||
Chemotherapy | No | 71 (11.3%) | 31 (20.7%) | 0.003 |
Yes | 560 (88.7%) | 119 (79.3%) | ||
Surgical resection | No | 26 (4.1%) | 95 (63.3%) | <0.001 |
Yes | 606 (95.9%) | 55 (36.7%) |
3-Year OS Rate | 3-Year OS Rate | |||||
---|---|---|---|---|---|---|
Variables | All Cases | p | Femoral OS | Pelvic OS | p | |
Location | Femoral | 73.7% | <0.001 | |||
Pelvis | 42.8% | |||||
Gender | Male | 68.3% | 0.818 | 72.9% | 45.7% | <0.001 |
Female | 67.4% | 74.6% | 39.0% | <0.001 | ||
Metastasis at presentation | M0 | 75.8% | <0.001 | 80.6% | 52.0% | <0.001 |
M1 | 29.3% | 33.9% | 19.7% | 0.002 | ||
Age at diagnosis | <40 years | 77.9% | <0.001 | 79.9% | 55.7% | <0.001 |
≥40 years | 48.5% | 55.8% | 37.3% | <0.001 | ||
<60 years | 74.2% | <0.001 | 76.6% | 59.5% | <0.001 | |
≥60 years | 41.8% | 56.9% | 19.0% | <0.001 | ||
Size | <12 cm | 73.2% | <0.001 | 77.6% | 51.5% | <0.001 |
≥12 cm | 56.7% | 64.4% | 32.2% | <0.001 | ||
Secondary | Primary | 68.3% | 0.085 | 73.8% | 43.5% | <0.001 |
Secondary | 48.2% | 62.5% | 25.0% | 0.163 | ||
Chemotherapy | Yes | 70.2% | <0.001 | 74.9% | 48.0% | <0.001 |
No | 52.1% | 64.0% | 22.4% | <0.001 | ||
Surgical resection | Yes | 75.5% | <0.001 | 76.0% | 68.9% | 0.329 |
No | 26.6% | 21.6% | 28.2% | 0.644 |
Variables | HR | 95% CI | p |
---|---|---|---|
Location: pelvis | 1.01 | 0.67–1.51 | 0.976 |
Gender: female | 1.06 | 0.82–1.36 | 0.679 |
Metastasis at presentation: yes | 3.56 | 2.62–4.84 | <0.001 |
Age ≥60 years | 2.96 | 2.15–4.06 | <0.001 |
Size ≥12 cm | 1.38 | 1.05–1.81 | 0.021 |
Secondary osteosarcoma | 0.96 | 0.42–2.21 | 0.919 |
Chemotherapy: yes | 0.92 | 0.63–1.34 | 0.661 |
Surgical resection: yes | 0.35 | 0.23–0.53 | <0.001 |
Patient Number (%) (n = 150) | Patient Number (%) after Propensity Score Matching (n = 92) | ||||||
---|---|---|---|---|---|---|---|
Variables | Resection | No Resection | p | Resection | No Resection | p | |
Gender | Male | 26 (47.3%) | 47 (49.5%) | 0.928 | 22 (47.8%) | 22 (47.8%) | 1.00 |
Female | 29 (52.7%) | 48 (50.5%) | 24 (52.2%) | 24 (52.2%) | |||
Metastasis at presentation | M0 | 51 (92.7%) | 58 (61.7%) | <0.001 | 42 (91.3%) | 43 (93.5%) | 1.00 |
M1 | 4 (7.3%) | 36 (38.3%) | 4 (8.7%) | 3 (6.5%) | |||
Age | <40 years | 19 (34.5%) | 26 (27.4%) | 0.460 | 17 (37.0%) | 17 (37.0%) | 1.00 |
≥40 years | 36 (65.5%) | 69 (72.6%) | 29 (63.0%) | 29 (63.0%) | |||
<60 years | 40 (72.7%) | 50 (52.6%) | 0.025 | 32 (69.6%) | 32 (69.6%) | 1.00 | |
≥60 years | 15 (27.3%) | 45 (47.4%) | 14 (30.4%) | 14 (30.4%) | |||
Size | <12 cm | 40 (74.1%) | 44 (47.8%) | 0.003 | 33 (71.7%) | 31 (67.4%) | 0.82 |
≥12 cm | 14 (25.9%) | 48 (52.2%) | 13 (28.3%) | 15 (32.6%) | |||
Secondary | Primary | 52 (94.5%) | 92 (96.8%) | 0.795 | 45 (97.8%) | 45 (97.8%) | 1.00 |
Secondary | 3 (5.5%) | 3 (3.2%) | 1 (2.2%) | 1 (2.2%) | |||
Chemotherapy | Yes | 44 (80.0%) | 75 (78.9%) | 1 | 39 (84.8%) | 40 (93.5%) | 1.00 |
No | 11 (20.0%) | 20 (21.1%) | 7 (15.2%) | 6 (13.0%) |
Variables | Odds Ratio | 95% CI | p |
---|---|---|---|
Gender: female | 1.24 | 0.57–2.69 | 0.583 |
Metastasis at presentation: yes | 0.167 | 0.052–0.53 | 0.002 |
Age ≥60 years | 0.299 | 0.12–0.75 | 0.010 |
Size ≥12 cm | 0.46 | 0.20–1.05 | 0.065 |
Secondary osteosarcoma | 3.25 | 0.46–23.0 | 0.238 |
Chemotherapy: yes | 0.754 | 0.26–2.19 | 0.605 |
Stage at Presentation | Age at Diagnosis | Surgical Resection | No. of Patients | 3-Year OS Rate | p |
---|---|---|---|---|---|
Localized | <60 years old | Yes | 36 | 83.0 | 0.005 |
Localized | <60 years old | No | 32 | 50.9 | |
Localized | ≥60 years old | Yes | 15 | 39.1 | 0.117 |
Localized | ≥60 years old | No | 26 | 22.0 | |
Metastatic | <60 years old | Yes | 4 | 75.0 | 0.251 |
Metastatic | <60 years old | No | 18 | 29.2 | |
Metastatic | ≥60 years old | Yes | 0 | N.A | N.A. |
Metastatic | ≥60 years old | No | 18 | 0.0 |
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Share and Cite
Takenaka, S.; Tamiya, H.; Wakamatsu, T.; Nakai, S.; Imura, Y.; Outani, H.; Yagi, T.; Kawai, A. Impact of Surgical Resection and Reasons for Poor Prognosis of Pelvic Osteosarcoma Based on the Bone Tumor Registry in Japan. Cancers 2021, 13, 3320. https://doi.org/10.3390/cancers13133320
Takenaka S, Tamiya H, Wakamatsu T, Nakai S, Imura Y, Outani H, Yagi T, Kawai A. Impact of Surgical Resection and Reasons for Poor Prognosis of Pelvic Osteosarcoma Based on the Bone Tumor Registry in Japan. Cancers. 2021; 13(13):3320. https://doi.org/10.3390/cancers13133320
Chicago/Turabian StyleTakenaka, Satoshi, Hironari Tamiya, Toru Wakamatsu, Sho Nakai, Yoshinori Imura, Hidetatsu Outani, Toshinari Yagi, and Akira Kawai. 2021. "Impact of Surgical Resection and Reasons for Poor Prognosis of Pelvic Osteosarcoma Based on the Bone Tumor Registry in Japan" Cancers 13, no. 13: 3320. https://doi.org/10.3390/cancers13133320