Survival and prognosis with osteosarcoma: outcomes in more than 2000 patients in the EURAMOS-1 (European and American Osteosarcoma Study) cohort.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Smeland Sigbjørn, Bielack Stefan S, Whelan Jeremy, Bernstein Mark, Hogendoorn Pancras, Krailo Mark D, Gorlick Richard, Janeway Katherine A, Ingleby Fiona C, Anninga Jakob, Antal Imre, Arndt Carola, Brown Ken L B, Butterfass-Bahloul Trude, Calaminus Gabriele, Capra Michael, Dhooge Catharina, Eriksson Mikael, Flanagan Adrienne M, Friedel Godehard, Gebhardt Mark C, Gelderblom Hans, Goldsby Robert, Grier Holcombe E, Grimer Robert, Hawkins Douglas S, Hecker-Nolting Stefanie, Sundby Hall Kirsten, Isakoff Michael S, Jovic Gordana, Kühne Thomas, Kager Leo, von Kalle Thekla, Kabickova Edita, Lang Susanna, Lau Ching C, Leavey Patrick J, Lessnick Stephen L, Mascarenhas Leo, Mayer-Steinacker Regine, Meyers Paul A, Nagarajan Raj, Randall R Lor, Reichardt Peter, Renard Marleen, Rechnitzer Catherine, Schwartz Cindy L, Strauss Sandra, Teot Lisa, Timmermann Beate, Sydes Matthew R, Marina Neyssa
Аннотация
METHODS: Patients eligible for EURAMOS-1 were aged ≤40 years with M0 or M1 skeletal high-grade osteosarcoma in which case complete surgical resection at all sites was deemed to be possible. A three-drug combination with methotrexate, doxorubicin and cisplatin was defined as standard chemotherapy, and between April 2005 and June 2011, 2260 patients were registered. We report survival outcomes and prognostic factors in the full cohort of registered patients.
RESULTS: For all registered patients at a median follow-up of 54 months (interquartile range: 38-73) from biopsy, 3-year and 5-year event-free survival were 59% (95% confidence interval [CI]: 57-61%) and 54% (95% CI: 52-56%), respectively. Multivariate analyses showed that the most adverse factors at diagnosis were pulmonary metastases (hazard ratio [HR] = 2.34, 95% CI: 1.95-2.81), non-pulmonary metastases (HR = 1.94, 95% CI: 1.38-2.73) or an axial skeleton tumour site (HR = 1.53, 95% CI: 1.10-2.13). The histological subtypes telangiectatic (HR = 0.52, 95% CI: 0.33-0.80) and unspecified conventional (HR = 0.67, 95% CI: 0.52-0.88) were associated with a favourable prognosis compared with chondroblastic subtype. The 3-year and 5-year overall survival from biopsy were 79% (95% CI: 77-81%) and 71% (95% CI: 68-73%), respectively. For patients with localised disease at presentation and in complete remission after surgery, having a poor histological response was associated with worse outcome after surgery (HR = 2.13, 95% CI: 1.76-2.58). In radically operated patients, there was no good evidence that axial tumour site was associated with worse outcome.
CONCLUSIONS: In conclusion, data from >2000 patients registered to EURAMOS-1 demonstrated survival rates in concordance with institution- or group-level osteosarcoma trials. Further efforts are required to drive improvements for patients who can be identified to be at higher risk of adverse outcome. This trial reaffirms known prognostic factors, and owing to the large numbers of patients registered, it sheds light on some additional factors to consider.