Prognostic Value of Histological Response to Chemotherapy in Osteosarcoma Patients Receiving Tumor-Bearing Frozen Autograft

Abstract

BackgroundA variety of surgical procedures are now available for tissue reconstruction after osteosarcoma excision, and an important prognostic factor is the evaluation of response to chemotherapy using histology. Although tumor-bearing autografts are useful tools for reconstruction, re-use of the primary tumor may make it difficult to assess the histological response to chemotherapy, since the entire tumor cannot be analyzed. Here, we analyzed the prognostic value of the histological response in the patients who received frozen tumor-bearing autografts for reconstruction.MethodRetrospective analysis of the medical records of 51 patients with high-grade osteosarcoma of the extremities was performed. All patients received reconstruction using frozen tumor-bearing autografts. Tumor necrosis was evaluated in extraskeletal masses and cancellous bone.ResultsFive-year overall survival of patients with good and poor response to chemotherapy was 82.9% and 46.4%, respectively (P = 0.044), and 5-year event-free survival was 57.7% and 36.0%, respectively (P = 0.329). Multivariate analysis revealed that a poor histological response to chemotherapy was a significant prognostic factor for overall survival (P = 0.033).ConclusionHistological response is an important and reliable prognostic factor in patients undergoing reconstruction using frozen tumor-bearing autografts.

Knee joint preservation surgery in osteosarcoma using tumour-bearing bone treated with liquid nitrogen

“…Pathological evaluations of response to neoadjuvant chemotherapy in case presentations were based on only a part of the tumour: curettage cancellous bone and/or extraskeletal mass; however, we have reported that the histological evaluations of small samples were correlated with the response to chemotherapy and the prognosis [29]. Secondly, comparison between two methods: the free-freezing method and pedicle-freezing method, was not enough to clarify the usefulness of the pedicle-freezing method in terms of bone union or complication of fractures because the patient numbers of each methods were small.…”

Impacts of Tumor Location, Nature and Bone Destruction of Extremity Osteosarcoma on Selection of Limb Salvage Operative Procedure

“…However, postoperative recovery is prolonged, full weight bearing ambulation usually being delayed. In addition, postoperative complications, including recurrence, fracture, infection and nonunion, are not negligible [3][4][5][6][7][35][36][37][38] . Mechanical reconstruction can achieve ideal tumor resection margins and allow instant weight bearing ambulation postoperatively.…”

Evaluation of P‐glycoprotein (Pgp) expression in human osteosarcoma by high‐throughput tissue microarray

“…Histological response of the surgically removed tumor to pre‐operative chemotherapy represents the most pivotal prognostic factor thus far . Patients with good histological response (necrosis percentage ≥ 90%) may have a better prognosis than those with poor histological response (necrosis percentage < 90%) . Previous investigations have had discrepant results due to the limited number of tissue samples.…”