A study of 853 high grade osteosarcomas from a single institution<b>—</b>Are outcomes in Indian patients different?

Puri, Ajay; Byregowda, Suman; Gulia, Ashish; Crasto, Saniya; Chinaswamy, Girish

doi:10.1002/jso.24809

Cited by 28 publications

(32 citation statements)

References 38 publications

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“…This, the largest documented series of stand‐alone intercalary ECRT grafts for primary extremity high grade diaphyseal tumors has demonstrated comparable local control and survival compared to other series using alternative methods of reconstruction . Our own series of 520 non metastatic osteosarcomas treated with limb salvage surgery (excluding ECRT) had a similar local recurrence rate of 10% . In the series by Mavrogenis et al 8% (12 of 151) of osteosarcomas reconstructed with a megaprosthesis had local recurrence while Zhang et al documented 9% (10 of 108) local recurrence in their study of megaprostheses for high‐grade osteosarcoma around the knee.…”

Section: Discussionmentioning

confidence: 50%

“…There were 53 male and 17 female patients with a mean age of 17 years (range 1-36 years). The femur was the most commonly involved bone (46) followed by tibia (17), humerus (6), and ulna (1).…”

Section: Methodsmentioning

confidence: 99%

“…1,16 Our own series of 520 non metastatic osteosarcomas treated with limb salvage surgery (excluding ECRT) had a similar local recurrence rate of 10%. 17 Hatano's study of retrieved reimplanted specimens of extracorporeal irradiated autogenous osteochondral grafts also showed no viable tumor in the samples. 21 A reconstruction technique should offer ease of applicability of the procedure, oncologic safety, minimal complications, and durability.…”

Section: Oncologic Safetymentioning

confidence: 97%

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Reconstructing diaphyseal tumors using radiated (50 Gy) autogenous tumor bone graft

Puri

Byregowda

Gulia

et al. 2018

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 50%

Section: Methodsmentioning

confidence: 99%

Section: Oncologic Safetymentioning

confidence: 97%

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Reconstructing diaphyseal tumors using radiated (50 Gy) autogenous tumor bone graft

Puri

Byregowda

Gulia

et al. 2018

Journal of Surgical Oncology

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“…All patients were nonmetastatic at presentation. ey received neoadjuvant and adjuvant chemotherapy as per the existing hospital protocol [7]. Sixty one of 720(8.4%) patients had diaphyseal disease.…”

Section: Patientsmentioning

confidence: 99%

Does Reconstruction with Reimplantation of Sterilized Tumor Bone Provide Survival Benefit in Diaphyseal Osteosarcoma?

Nayak

Gulia

Puri

2020

Sarcoma

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Does reimplantation of sterilized tumor bone for reconstruction provide outcome benefits in intercalary osteosarcoma based on the potential immunogenic effect of reimplanted sterilized tumor tissue? Of 720 cases of surgically treated high-grade osteosarcoma patients treated at our institute from 2006 to 2013, 61 had predominantly diaphyseal disease. All patients were nonmetastatic at presentation. Patient and tumor characteristics, treatment details, and local recurrence-free, metastasis-free, and overall survival were compared for 24 patients who had reconstruction with sterilized tumor bone reimplantation vs 37 who did not. Both the groups were well matched in terms of baseline characteristics. Means were compared with the t-test, proportions with the chi-square test, and survival with the log-rank test. The Kaplan‐Meier method was used to construct time to event curves. Cox proportional hazard regression modeling was employed for multivariate time to event analysis. Twenty-two had extracorporeal radiation and reimplantation (ECRT) with or without the vascularised fibula. Fifty-gray single dose was used in all cases. Two had pasteurization and reimplantation. Thirty seven had non-reimplantation reconstructions (including intercalary or osteoarticular endoprosthesis, pedicled bone grafts, rotation-plasty, and amputations). Five-year local recurrence-free survival was 85% for reimplantation and 97% for non-reimplantation groups (p=0.17). Five-year metastasis-free survival was 63% and 54%, respectively (p=0.44). Five-year overall survival was 70% and 58%, respectively (p=0.39). The data from this study did not demonstrate significantly better local recurrence-free, distant relapse-free, or overall survival benefit in the tumor bone reimplantation group.

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“…While the survival factors associated with metastatic osteosarcoma are complex and controversial, surgical resection is widely accepted as a beneficial treatment method. Some retrospective studies have reported the benefits of primary tumour resection (PTR) and primary tumour and metastatic site resection (PTMR) [7][8][9]. In general, surgical resection, combined with chemotherapy, has been shown to result in better prognosis [10,11].…”

Section: Introductionmentioning

confidence: 99%

A population-based propensity-matched study of regional dissections in patients with metastatic osteosarcoma

et al. 2020

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Background: The survival rates of patients with metastatic osteosarcoma are poor, and the prognosis is closely related to the choice of treatment, especially surgery. This study aimed to evaluate the survival outcomes of patients with metastatic osteosarcoma undergoing regional dissections. Methods: We collected data on patients with metastatic osteosarcoma between 2004 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier curves were used to compare overall survival (OS) and cancer-specific survival (CSS), while univariate and multivariate Cox regression analyses were used to evaluate outcomes. Propensity score matching (PSM) was used to minimize the effects of confounding factors. Results: The SEER database had records of 2768 patients diagnosed with osteosarcoma, of whom 398 were included in our study. Of the included patients, 116 (29.15%) underwent regional dissections, while 282 (70.85%) underwent non-regional dissections. The univariate and multivariate Cox regression analyses, prior to PSM, showed that OS (hazard ratio (HR): 0.34, 95% confidence interval (CI): 0.26-0.44, P<0.001 and HR: 0.47, 95% CI: 0.35-0.64, P< 0.001, respectively) and CSS (HR: 0.33, 95% CI: 0.25-0.43, P<0.001 and HR: 0.46, 95% CI: 0.34-0.63, P<0.001, respectively) were better in patients who underwent regional dissections than those who underwent non-regional dissections. Compared with non-regional dissections, regional dissections, which included both primary tumour resection (PTR) and primary tumour and metastatic site resection (PTMR), were associated with better OS (P<0.001) and CSS (P<0.001) . However, the survival outcomes following PTR and PTMR showed no significant difference. After PSM, patients in the regional dissection group still had a higher OS (P<0.001) and CSS (P<0.001) than those in the non-regional dissection group. Conclusions: Compared with non-regional dissection, regional dissection resulted in better survival in patients with metastatic osteosarcoma.

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A study of 853 high grade osteosarcomas from a single institution—Are outcomes in Indian patients different?

Abstract: Our patients appeared to have poorer survival compared to most Western data, possibly attributable to large tumors. In contrast to existing data, males (71%) were predominantly affected and only patients with 100% necrosis qualified as good responders regarding OS.

Cited by 28 publications

References 38 publications

Reconstructing diaphyseal tumors using radiated (50 Gy) autogenous tumor bone graft

Reconstructing diaphyseal tumors using radiated (50 Gy) autogenous tumor bone graft

Does Reconstruction with Reimplantation of Sterilized Tumor Bone Provide Survival Benefit in Diaphyseal Osteosarcoma?

A population-based propensity-matched study of regional dissections in patients with metastatic osteosarcoma

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