1 / 21

Shintaro Iwata 1 Akira Kawai 2 Toru Hiruma 3 Tsukasa Yonemoto 1

CTOS 17th Annual M eeting. 17 th Nov. 2012. Prognostic Factors In Elderly Osteosarcoma Patients - A Multi-Institutional Retrospective Study of 90 Cases -. Shintaro Iwata 1 Akira Kawai 2 Toru Hiruma 3 Tsukasa Yonemoto 1

early
Download Presentation

Shintaro Iwata 1 Akira Kawai 2 Toru Hiruma 3 Tsukasa Yonemoto 1

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CTOS 17th Annual Meeting 17th Nov. 2012 Prognostic Factors In Elderly Osteosarcoma Patients - A Multi-Institutional Retrospective Study of 90 Cases - Shintaro Iwata1Akira Kawai2Toru Hiruma3 Tsukasa Yonemoto1 Masanobu Takeyama3NaofumiAsano2HirotoKamoda1 Takeshi Ishii1 1. Division of Orthopedic Surgery, Chiba Cancer Center, Chiba, Japan 2. Division of Orthopaedic Surgery, National Cancer Center Hospital, Tokyo, Japan 3. Department of Orthopaedic Surgery, Kanagawa Cancer Center, Yokohama, Japan

  2. Incidence of osteosarcoma in elderly patientsin Japan ≧40 years <40 years 2007 1989 1996 1975 2003 1982 (from Bone tumor registry in Japan)

  3. Outcome and prognostic factors of elderly OS - Doeschemotherapy work well ?? -

  4. Aim of this study • To clarify which prognostic factors • are associated with outcomes in patients • with osteosarcoma over 40 years old.

  5. Patients and Methods Setting multi-institutional retrospective study Kanagawa Cancer Center (Yokohama) National Cancer Center Hospital (Tokyo) Chiba Cancer Center (Chiba)

  6. Patients and Methods • Patients eligibility • diagnosed as a conventional high-grade osteosarcoma • age at diagnosis ≧40 years - 90 cases Period: 1-244 months (median: 27months)

  7. Patients and Methods • Statistical analysis • prognostic factor analysis • tumor-related factors • (age, sex, site, metastasis at diagnosis) • treatment-related factors • (surgery and chemotherapy) Survival rate (Kaplan-Meier method) Univariate analysis (log-rank test) Multivariate analysis (Cox’s proportional hazards model)

  8. Result1 Demographic data Tumor-related factors Age Sex Median 61years Female 50 (56%)

  9. Result1 Demographic data Tumor-related factors Site Stage Ⅳb 5 (6%) Ⅱa 16 (18%) Ⅳa 19 (21%) Pelvis 29 (32%) Extremity 44 (49%) Ⅱb 47 (52%) Trunk 17 (19%) Ⅲ 3 (3%)

  10. Result1 Demographic data Treatment-related factors Surgical margin Definitive surgery Local therapy Not performed 5(6%) Unknown 6(9%) Marginal 3(4%) CIRT 9(10%) Intra 11(16%) No 34 (38%) RT 9(10%) Yes 56 (62%) Surgery 59 (66%) Surgery+RT 8(9%) Wide 46 (69%)

  11. Result1 Demographic data Treatment-related factors Chemotherapy Course：1~18 (median 6) Neoadjuvant 21 (23%) cases Not performed 33 (37%) Pre/post-surgery 27 (30%) After relapse 9(10%) 1-3 4-6 7-9 10- N.A.

  12. Result2 Survivals Overall survivals Event-free survivals Alive Dead 39 51 Distant failure Local failure 42 12 5-year OAS 41.5% (95%CI 31.3-52.6%) 5-year EFS 29.1% (95%CI 20.5-39.5%) Period (months) Period (months)

  13. Result3 Prognostic factor analysis All patients (90 cases) Univariateanalysis

  14. Result3 Prognostic factor analysis Definitive surgery cases (56 cases) Definitive surgery + M0 cases (45 cases)

  15. Result3 Prognostic factor analysis All patients (90 cases) Multivariate analysis OAS EFS

  16. Result4 Subgroup analysis All patients 5y-OAS 41.5% Period (months)

  17. Result4 Subgroup analysis All patients 5y-OAS 41.5% M0(74%) 50.8% Period (months)

  18. Result4 Subgroup analysis All patients 5y-OAS 41.5% M0(74%) 50.8% Period (months) M0+Deff.Surg. (48%) 68.3%

  19. Result4 Subgroup analysis All patients 5y-OAS 41.5% M0(74%) 50.8% Period (months) M0+Deff.Surg. (48%) 68.3% M0+Deff.Surg.+Extremity (34%) 71.7%

  20. Discussion Prognostic factor ・Tumor-related factor: Site, Mets at diagnosis ・Treatment-related factor: Definitive surgery Surgical margin ・No impact on the outcome with the addition of CTx Hypothesis: CTx is not necessary for the patients of M0 who received definitive surgery.

  21. Thank you for your attention.

More Related