The prognosis for patients with osteosarcoma who have received prior manipulative therapy

Abstract

We evaluated the long-term outcome of patients with an osteosarcoma who had undergone prior manipulative therapy, a popular treatment in Asia, and investigated its effects on several prognostic factors. Of the 134 patients in this study, 70 (52%) patients had manipulative therapy and 64 (48%) did not. The age, location, and size of tumour were not significantly different between the groups. The five-year overall survival rate was 58% and 92% in the groups with and without manipulative therapy (p = 0.004). Both the primary and overall rates of lung metastasis were significantly higher in the manipulative group (primary: 32% vs 3%, p = 0.003; overall lung metastasis rate: 51.4% vs 18.8%, p < 0.001). Patients who had manipulative therapy had higher local recurrence rates in comparison to patients who did not (29% vs 6%, p = 0.011). The prognosis for patients with osteosarcoma who had manipulative therapy was significantly poorer than those who had not. Manipulative therapy was an independent factor for survival. This form of therapy may serve as a mechanism to accelerate the spread of tumour cells, and therefore must be avoided in order to improve the outcome for patients with an osteosarcoma.

The Prognosis of Patients with Primary Osteosarcoma Who Have Undergone Unplanned Therapy

“…However, this result was affected by differences among patients, tumor characteristics and treatment methods. The tumor volume at the time of diagnosis has been shown to be a significant predictive factor of outcome (16,18). In our study, the mean tumor volume was smaller in the unplanned treatment group, and this may explain why there was no difference in 5-year survival rates between the two groups.…”

Manipulation Therapy Prior to Diagnosis Induced Primary Osteosarcoma Metastasis—From Clinical to Basic Research

“…Recently, the alternative therapies on cancer care became more popular and acceptable in the world[25], [26] including complementary medicine or supportive therapy such as MT or massage[27]. However, many adverse effects concerning the possibility to promote metastasis have been reported[6], [9], [28]. From clinical findings, many OS patients seek for manipulative therapy to release the uncomfortable symptoms such as swelling or pain before diagnosis without alerting the possibility of OS exist[6].…”

“…However, many adverse effects concerning the possibility to promote metastasis have been reported[6], [9], [28]. From clinical findings, many OS patients seek for manipulative therapy to release the uncomfortable symptoms such as swelling or pain before diagnosis without alerting the possibility of OS exist[6]. In our clinical results from 200 OS patients, the metastasis rate were higher and the survival rate were lower in OS patients who had received MT treatment before diagnosis compared with MT (−) patients, respectively (Table 1).…”

“…Because of the young age and the most common symptoms of OS are pain and swelling, many patients seek for manipulative therapy (MT), such as massage, Tuina, or other kinds of complimentary treatments prior to diagnosis to release these uncomfortable symptoms, especially in Asian countries[6]. The full-body massage therapy also known and applied for release tumor metastasis-induced bone pain on cancer patients[7].…”

“…In 2004, Diaz et al provided the evidence that mechanical treatments induced distal metastasis by lymphoid leaking[9]. Our previous clinical study has demonstrated that patients receiving MT prior to diagnosis of OS shows lower survival rate accompanied with higher local recurrence and lung metastasis rate[6]. However, the mechanisms of MT-induced metastasis of OS remains further elucidated.…”