Clinical Prognostic Factors and Outcome in Pediatric Osteosarcoma: Effect of Delay in Local Control and Degree of Necrosis in a Multidisciplinary Setting in Lebanon
PURPOSE: Outcomes in pediatric osteosarcoma have dramatically improved over the past few decades, with overall survival rates of 70% and 30% for patients with localized and metastatic disease, respectively. PATIENTS AND METHODS: We retrospectively reviewed clinical characteristics and outcomes of 38...
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doaj-6c0349cbd08c49aab18ed975b4c244b72020-11-25T03:34:15ZengAmerican Society of Clinical OncologyJournal of Global Oncology2378-95062019-04-0151810.1200/JGO.17.002411Clinical Prognostic Factors and Outcome in Pediatric Osteosarcoma: Effect of Delay in Local Control and Degree of Necrosis in a Multidisciplinary Setting in LebanonBilal Abou Ali0Mayssa Salman1Khaled M. Ghanem2Fouad Boulos3Rachid Haidar4Said Saghieh5Samir Akel6Samar A. Muwakkit7Hassan El-Solh8Raya Saab9Hani Tamim10Miguel R. Abboud11Children's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonChildren's Cancer Institute, American University of Beirut, Beirut, LebanonPURPOSE: Outcomes in pediatric osteosarcoma have dramatically improved over the past few decades, with overall survival rates of 70% and 30% for patients with localized and metastatic disease, respectively. PATIENTS AND METHODS: We retrospectively reviewed clinical characteristics and outcomes of 38 patients treated between 2001 and 2012 at a single institution in Lebanon. All patients received a uniform three-drug chemotherapy regimen consisting of cisplatin, doxorubicin, and methotrexate. Ifosfamide and etoposide were added to the adjuvant treatment regimen in case of metastatic disease and/or poor degree of tumor necrosis (< 90%). RESULTS: After a median follow-up of 61 months (range, 8 to 142 months), patients with localized disease had 5-year overall and event-free survival rates of approximately 81% and 68%, respectively, whereas for metastatic disease, they were approximately 42%. The most common primary site was the long bones around the knee (n = 34; 89.5%). Six patients (15.8%) had metastatic disease to lungs, and three (7.9%) had synchronous multifocal bone disease with lung metastases. Adverse prognostic factors included nonlower extremity sites, metastasis, poor degree of necrosis, and delay of more than 4 weeks in local control. In bivariable analysis, only degree of necrosis was a prognostic predictor for survival and disease recurrence. CONCLUSION: Treatment of pediatric osteosarcoma in a multidisciplinary cancer center in Lebanon resulted in survival similar to that in developed countries. Delay in local control was associated with worse outcome. The only statistically significant inferior outcome predictor was poor degree of necrosis at the time of local control.http://ascopubs.org/doi/10.1200/JGO.17.00241 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bilal Abou Ali Mayssa Salman Khaled M. Ghanem Fouad Boulos Rachid Haidar Said Saghieh Samir Akel Samar A. Muwakkit Hassan El-Solh Raya Saab Hani Tamim Miguel R. Abboud |
spellingShingle |
Bilal Abou Ali Mayssa Salman Khaled M. Ghanem Fouad Boulos Rachid Haidar Said Saghieh Samir Akel Samar A. Muwakkit Hassan El-Solh Raya Saab Hani Tamim Miguel R. Abboud Clinical Prognostic Factors and Outcome in Pediatric Osteosarcoma: Effect of Delay in Local Control and Degree of Necrosis in a Multidisciplinary Setting in Lebanon Journal of Global Oncology |
author_facet |
Bilal Abou Ali Mayssa Salman Khaled M. Ghanem Fouad Boulos Rachid Haidar Said Saghieh Samir Akel Samar A. Muwakkit Hassan El-Solh Raya Saab Hani Tamim Miguel R. Abboud |
author_sort |
Bilal Abou Ali |
title |
Clinical Prognostic Factors and Outcome in Pediatric Osteosarcoma: Effect of Delay in Local Control and Degree of Necrosis in a Multidisciplinary Setting in Lebanon |
title_short |
Clinical Prognostic Factors and Outcome in Pediatric Osteosarcoma: Effect of Delay in Local Control and Degree of Necrosis in a Multidisciplinary Setting in Lebanon |
title_full |
Clinical Prognostic Factors and Outcome in Pediatric Osteosarcoma: Effect of Delay in Local Control and Degree of Necrosis in a Multidisciplinary Setting in Lebanon |
title_fullStr |
Clinical Prognostic Factors and Outcome in Pediatric Osteosarcoma: Effect of Delay in Local Control and Degree of Necrosis in a Multidisciplinary Setting in Lebanon |
title_full_unstemmed |
Clinical Prognostic Factors and Outcome in Pediatric Osteosarcoma: Effect of Delay in Local Control and Degree of Necrosis in a Multidisciplinary Setting in Lebanon |
title_sort |
clinical prognostic factors and outcome in pediatric osteosarcoma: effect of delay in local control and degree of necrosis in a multidisciplinary setting in lebanon |
publisher |
American Society of Clinical Oncology |
series |
Journal of Global Oncology |
issn |
2378-9506 |
publishDate |
2019-04-01 |
description |
PURPOSE: Outcomes in pediatric osteosarcoma have dramatically improved over the past few decades, with overall survival rates of 70% and 30% for patients with localized and metastatic disease, respectively. PATIENTS AND METHODS: We retrospectively reviewed clinical characteristics and outcomes of 38 patients treated between 2001 and 2012 at a single institution in Lebanon. All patients received a uniform three-drug chemotherapy regimen consisting of cisplatin, doxorubicin, and methotrexate. Ifosfamide and etoposide were added to the adjuvant treatment regimen in case of metastatic disease and/or poor degree of tumor necrosis (< 90%). RESULTS: After a median follow-up of 61 months (range, 8 to 142 months), patients with localized disease had 5-year overall and event-free survival rates of approximately 81% and 68%, respectively, whereas for metastatic disease, they were approximately 42%. The most common primary site was the long bones around the knee (n = 34; 89.5%). Six patients (15.8%) had metastatic disease to lungs, and three (7.9%) had synchronous multifocal bone disease with lung metastases. Adverse prognostic factors included nonlower extremity sites, metastasis, poor degree of necrosis, and delay of more than 4 weeks in local control. In bivariable analysis, only degree of necrosis was a prognostic predictor for survival and disease recurrence. CONCLUSION: Treatment of pediatric osteosarcoma in a multidisciplinary cancer center in Lebanon resulted in survival similar to that in developed countries. Delay in local control was associated with worse outcome. The only statistically significant inferior outcome predictor was poor degree of necrosis at the time of local control. |
url |
http://ascopubs.org/doi/10.1200/JGO.17.00241 |
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