Analysis of prognostic factors in 333 Chinese patients with high-grade osteosarcoma treated by multidisciplinary combined therapy

Aim To investigate prognostic factors for long-term outcomes in Chinese patients with high-grade osteosarcoma of the extremities or trunk treated by multidisciplinary combined therapy. Methods In total, 333 consecutive patients with non-metastatic or primary metastatic high-grade osteosarcoma of the extremities or trunk were retrospectively reviewed to analyze the correlation between survival and sex, age, site, histological type, clinical stage, alkaline phosphatase (ALP) level, preoperative chemotherapy or not, response to preoperative chemotherapy, postoperative chemotherapy cycles and manner of surgery. The combined therapy included preoperative and postoperative chemotherapy as well as limb salvage surgery or amputation. Results The median survival time was 52months for all 333 patients. Univariate analysis revealed that sex, ALP level, preoperative chemotherapy and cycle numbers of postoperative chemotherapy may influence the prognosis of high-grade osteosarcoma of the extremities or trunk. Multivariate analysis revealed that the female, a normal ALP level, preoperative chemotherapy with good response and 4 cycles of postoperative chemotherapy correlated with a better outcome. Conclusion Preoperative chemotherapy is important in high-grade osteosarcoma treatment and a good response to it is an important marker of prognosis. It should be given with cycles of postoperative chemotherapy after surgery.