INCREASED SURVIVAL, LIMB PRESERVATION, and PROGNOSTIC FACTORS for OSTEOSARCOMA

INCREASED SURVIVAL, LIMB PRESERVATION, and PROGNOSTIC FACTORS for OSTEOSARCOMA

Autor Petrilli, Antonio Sergio Autor UNIFESP Google Scholar
Gentil, F. C. Google Scholar
Epelman, S. Google Scholar
Lopes, L. F. Google Scholar
Bianchi, A. Google Scholar
Lopes, A. Google Scholar
Figueiredo, MTA Google Scholar
Marques, E. Google Scholar
Debellis, N. Google Scholar
Consentino, E. Google Scholar
Prospero, D. Google Scholar
Decamargo, O. P. Google Scholar
Oliveira, N. R. Google Scholar
Franco, E. Google Scholar
Jaffe, N. Google Scholar
Instituição LUDWIG INST CANC RES
UNIV TEXAS
Universidade de São Paulo (USP)
AC CAMARGO
São Paulo HOSP
Universidade Federal de São Paulo (UNIFESP)
Resumo Preoperative intraarterial (IA) cisplatin (CDP) was administered to 92 patients with nonmetastatic osteosarcoma. the ages of the patients ranged from 4 to 28 years. Sixty-four patients (70%) received 2 or 3 preoperative courses and 28 (30%) received 4 or more. Sixty-two specimens were available for pathologic examination to assess the degree of tumor necrosis. More than 90% tumor destruction was observed in 16 of 42 patients (38%) who received 1 to 3 preoperative courses as opposed to 17 of 20 (85%) who received 4 or more courses. Patients who received 4 or more courses had a 2-fold probability of achieving more than 90% tumor necrosis, and 68% underwent conservative surgery. of those who received 3 or less courses, 23% underwent conservative surgery. Postoperatively, patients were treated with intravenous (IV) CDP alternating with doxorubicin (ADR) (Adriamycin, Dria Laboratories, Columbus, OH). Pulmonary metastases developed in 36 patients, bone metastases in 2, and local recurrence in 6. Two patients died of cardiac failure without evidence of disease. Thus, 46 patients (50%) were continuously free of disease 18 to 78 months after diagnosis. Univariate and multivariate analyses showed that male sex, low grade preoperative chemotherapy-induced necrosis, and nonosteoblastic histologic condition were prognostic factors predictive of recurrence, while male sex and large tumor size were prognostic factors predictive of death. These results are comparable with those reported by other centers and are superior to our previous experiences that yielded survival rates of 5% to 10%. A substantial number of patients also had the opportunity to achieve tumor removal with conservative surgery.
Idioma Inglês
Data de publicação 1991-08-15
Publicado em Cancer. New York: Wiley-liss, v. 68, n. 4, p. 733-737, 1991.
ISSN 0008-543X (Sherpa/Romeo, fator de impacto)
Publicador Wiley-Blackwell
Extensão 733-737
Fonte http://dx.doi.org/10.1002/1097-0142(19910815)68:4<733
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:A1991FY94700011
Endereço permanente http://repositorio.unifesp.br/handle/11600/25213

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