Prognostic factors and survival rate of osteosarcoma: A single‐institution study

Ismail, Wan Faisham Wan; Saad, Arman Zaharil Mat; Al-Saigh, Laith Nafaa; Azman, Mat Z Nor; Musa, Kamarul Imran; Biswal, Biswa Mohan; Bhavaraju, Venkata Mk; Salzihan, Salleh; Jaafar, Hasnan; Aziz, Mohd Ezane; Nasir, Ariffin; Mohamad, Norsarwany; Ziyadi, Mohamad G; Sulaiman, Wan Azman Wan; Halim, Ahmad Sukari; Zulmi, W

doi:10.1111/ajco.12346

Cited by 83 publications

(74 citation statements)

References 18 publications

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“…Although there was one recent article stating that histological necrosis after chemotherapy did not significantly influence survival [28], histological response seems to be one of the generally-accepted significant prognostic factors in osteosarcoma [29] [30]. In our study, the patients with poor histologic response presented much more unfavorable survival rates than those with good histologic response, regardless of the age, and these results were statistically significant (p = 0.018).…”

Section: Discussioncontrasting

confidence: 45%

Is Osteosarcoma between the Two Peak Ages Different?

Chung¹,

Cho²,

Jeon³

et al. 2018

JCT

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Background: Unlike two known peak age groups (10 -14 and older than 65 years of age), there was relatively scant attention in osteosarcoma patients between them, and previous reports had analyzed other than Asians. Therefore we conducted this study with Korean patients and focused on 20 -40 years of age, then investigated age-specific or race-specific meaningful outcomes. Materials and Methods: 379 patients who were newly diagnosed as osteosarcoma in two Korean major cancer hospitals from September 1986 to July 2015 with more than 2-year follow-up were retrospectively studied. There were 290 patients with 20 -40 years of age, 60 patients aged 19 or younger, and 29 patients aged 41 or older. Age at diagnosis, gender, location of primary lesion, metastasis at diagnosis, histologic subtypes, histologic response were analyzed as prognostic factors by overall survival (OS) and event-free survival (EFS) rates. Results: Primary pelvic lesion and poor histologic response were significantly unfavorable prognostic factors, but not age-specific. However, proportion of metastasis at diagnosis was significantly highest in 20 -40 years of age group. For the age at diagnosis, older patients presented poorer 5-year OS and EFS rates, but for 10-year, 20 -40 years of age group showed unusually better prognosis than younger age's, with statistic significance in OS rates but not in EFS rates. Conclusion: Osteosarcoma patients with 20 -40 years of age in Korea presented relatively better prognosis after longer-term 10-year despite their late diagnosis causing more metastasis at diagnosis, which emphasized expedite diagnosis and appropriate treatment to expect much better prognosis than peak age groups.

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Section: Discussioncontrasting

confidence: 45%

Is Osteosarcoma between the Two Peak Ages Different?

Chung¹,

Cho²,

Jeon³

et al. 2018

JCT

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“…Thirty‐five studies met the inclusion criteria (Table ): very high HDI (n = 23), high HDI (n = 7), and medium/low HDI (n = 5) . Figure depicts the prevalence of metastatic OS at diagnosis stratified by HDI group.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of Metastasis at Diagnosis of Osteosarcoma: An International Comparison

Marko

Diessner

Spector

2016

Pediatric Blood & Cancer

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Background Osteosarcoma is the most common primary malignant bone tumor in many countries, with metastatic disease responsible for most patient deaths. This study compares the prevalence of metastatic osteosarcoma at diagnosis across countries to inform the critical question of whether diagnostic delay or tumor biology drives metastases development prior to diagnosis. Procedure A literature search of the PubMed database was conducted to compare the prevalence of metastatic disease at the time of OS diagnosis between countries. A pooled prevalence with 95% confidence intervals was calculated for each study meeting inclusion criteria. Studies were grouped for analysis based on human development index (HDI) scores. Results Our analysis found an 18% (95% CI: 15%, 20%) average global pooled proportion of metastasis at osteosarcoma diagnosis. The average prevalence of metastasis at diagnosis increased as HDI groupings decreased, with very high HDI, high HDI, and medium/ low HDI groups found to be 15% (95% CI: 13%, 17%), 20% (95% CI: 14%, 28%), and 31% (95% CI: 15%, 52%), respectively. Conclusions Our evidence suggests there is a biological baseline for metastatic OS at diagnosis, which is observed in countries with very high HDI. In countries with medium/ low HDI, where there are more barriers to accessing healthcare, the higher prevalence of metastasis may result from treatment delay or an artificial prevalence inflation due to patients with less severe symptoms not presenting to clinic. Additional research in countries with medium/ low HDI may reveal that earlier detection and treatment could improve patient outcomes in those countries.

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“…Statistically, about 85% of patients diagnosed with osteosarcoma show metastasis (Faisham et al, 2017). Approximately 80-90% of these tumors occur on extremities, especially in metaphysis, distal femur, proximal tibia, and proximal humerus.…”

Section: Introductionmentioning

confidence: 99%

The induction of ferroptosis by impairing STAT3/Nrf2/GPx4 signaling enhances the sensitivity of osteosarcoma cells to cisplatin

Liu

Wang

2019

Cell Biology International

195

120

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Recent studies have indicated that promoting ferroptosis is a promising approach to attenuate drug resistance of cancer cells. Hence, this study aimed to induce ferroptosis in osteosarcoma cells, thereby increasing the sensitivity to cisplatin. Osteosarcoma cells MG63 and Saos-2 were incubated with increasing doses of cisplatin to generate cisplatin-resistant strains, MG63/DDP and Saos-2/DDP. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and flow cytometry assays were performed to evaluate cell proliferation and cell death, respectively. Malondialdehyde (MDA), reactive oxygen species (ROS), and lipid oxidation in cells were measured to evaluate the degree of cell ferroptosis. MG63/ DDP and Saos-2/DDP cells showed increased viability and decreased death rate compared with MG63 and Saos-2 cells, respectively, upon cisplatin treatment. Western blotting analysis indicated that protein levels of p-STAT3 (Ser727), nuclear factor erythroid 2-related factor 2 (Nrf2), and glutathione peroxidase 4 (GPx4) in drug-resistant strains increased significantly in response to cisplatin. Co-treatment with cisplatin and agonists of ferroptosis, Erastin, and RSL3, remarkably increased MDA, ROS, lipid oxidation, and sensitivity to cisplatin, in MG63/DDP and Saos-2/DDP cells. Similar results were observed by co-treatment of cells with cisplatin and a STAT3 inhibitor. The reduction of protein levels of p-STAT3 (Ser727), Nrf2, and GPx4 in MG63/DDP and Saos-2/DDP cells resulted in increased ferroptosis and sensitivity to cisplatin. These results indicate that cisplatin-resistant osteosarcoma cells inhibited ferroptosis after exposure to low doses of cisplatin. However, ferroptosis agonists and STAT3 inhibitor reactivated ferroptosis in the cells and consequently increased sensitivity to cisplatin. This study demonstrates a new approach to attenuate resistance of osteosarcoma to cisplatin in vitro.

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Prognostic factors and survival rate of osteosarcoma: A single‐institution study

Cited by 83 publications

References 18 publications

Is Osteosarcoma between the Two Peak Ages Different?

Is Osteosarcoma between the Two Peak Ages Different?

Prevalence of Metastasis at Diagnosis of Osteosarcoma: An International Comparison

The induction of ferroptosis by impairing STAT3/Nrf2/GPx4 signaling enhances the sensitivity of osteosarcoma cells to cisplatin

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