Initial tumor size is an important and easily obtainable prognostic factor in osteosarcoma and may serve as a basis for risk-adapted therapy. It is best represented by the absolute three-dimensional measure ATV. There is a cut-off point regarding the incidence of metastases at a tumor volume of approximately 150 cm3 as calculated from two-plane x-ray films.

In a retrospective analysis on 128 patients from the trials COSS-80, -82, -85 and -86 initial x-ray pictures were evaluated for tumor diameters in three planes and the prognostic meaning on survival was assessed. In a subset of patients (n = 27) the measured values were compared to values obtained by CT-Scan and a good correlation (r = 0.69) was found. Several parameters for tumor size were defined: absolute tumor length (ATL), relative tumor length (RTL, proportion of tumor to the length of the involved bone), absolute tumor volume (ATV, calculated by the ellipsoid formula) and relative tumor volume (RTL, tumor volume referred to the body surface area) and univariate and multivariate survival analysis were performed. Univariate analysis of metastasis free survival (MFS) revealed a high prognostic significance of the ATL, the ATV and the RTV. The RTL in this patient group demonstrated a tendency only toward an inferior prognosis in larger tumors. None of the patients with a ATV < 70 ml (n = 19) and only one of 33 patients with an ATV < 100 ml relapsed. Cox regression analysis was performed including the variables age, sex, site and response (> 90% tumor necrosis) in 84 patients. ATL and RTL do not enter the model, while the response proves its significance as a valid prognostic factor with a p-value of 0.0004. Adding the ATV as the measure of tumor size to the model it enters as the first term (p = 0.0000) followed by the response (p = 0.0002).(ABSTRACT TRUNCATED AT 250 WORDS)

Objective: To study the age related radiological finding in pulmonary tuberculosis. Study design: A cross sectional study. Place and duration of study: From January 2009 to December 2009 pulmonary department of Bahawal Victoria Hospital Bahawal Pur. Patients and method: The cases diagnosed as pulmonary tuberculosis of either gender above age of 12 years were included in the study. Patients suffering from extra pulmonary tuberculosis, treatment failure, relapse, drug resistant tuberculosis and HIV sero-positive patients were excluded from the study. Patients were divided into groups according to the age. Group 1 consist of patients having age ≥ 50years while group 2 consist of patients having <50 years. Data was recorded on the Proforma and was analyzed statistically on SPSS 11. Results: this study consists of 106 patients and divided into two groups. It has been found that apical zone of lung involvement was more common in patients younger than 50 years while involvement of lower zone was more common in patients with age ≥50years. No significant difference was found regarding the involvement of middle zone, multiple zones and the type of lesions as the p-value was >0.05. Conclusions: the elderly patients with pulmonary tuberculosis have predominant involvement of lower zones. So, lower zone involvement of radiological lesions should be evaluated for pulmonary tuberculosis to start the treatment earlier and to minimize the risk of missing the diagnosis.

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