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Title: Increased survival, limb preservation, and prognostic factors for osteosarcoma
Authors: Petrilli, Antonio Sergio [UNIFESP]
Gentil, Fernando C.
Epelman, Sidnei
Lopes, Luiz Fernando
Bianchi, Alois
Lopes, Ademar
Figueiredo, Marco Tulio de Assis
Marques, Elvira
Bellis, Normando de
Consentino, Elio
Prospero, Donato
Camargo, Olavo Pires de
Oliveira, Nanni R.
Franco, Eduardo
Jaffe, Norman
Universidade de São Paulo (USP)
São Paulo HOSP
Universidade Federal de São Paulo (UNIFESP)
Issue Date: 15-Aug-1991
Publisher: Wiley-Blackwell
Citation: Cancer. New York: Wiley-liss, v. 68, n. 4, p. 733-737, 1991.
Abstract: 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.
ISSN: 0008-543X
Other Identifiers:<733::AID-CNCR2820680412>3.0.CO;2-0
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