Osteosarcoma natural history, complications and prognosis: Difference between revisions
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===Size of the primary tumor=== | ===Size of the primary tumor=== | ||
*Larger tumors have a worse prognosis than smaller tumors. | *Larger tumors have a worse prognosis than smaller tumors. | ||
*Serum lactate dehydrogenase (LDH), which also correlates with outcome, is a likely surrogate for tumor volume. | |||
===Metastatic disease=== | ===Metastatic disease=== | ||
Revision as of 15:12, 22 September 2015
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Osteosarcoma Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Prognosis
Pretreatment factors that influence outcome include the following:
Primary tumor site
Pelvis
- Survival rates for patients with pelvic primary tumors are 20% to 47%.
- Complete surgical resection is associated with positive outcome for osteosarcoma of the pelvis.
Craniofacial/head and neck
- In patients with craniofacial osteosarcoma, those with mandibular tumors have a significantly better prognosis than do patients with extragnathic tumors.
Extraskeletal
With current combined-modality therapy, the outcome for patients with extraskeletal osteosarcoma appears to be similar to that for patients with primary tumors of bone.
Size of the primary tumor
- Larger tumors have a worse prognosis than smaller tumors.
- Serum lactate dehydrogenase (LDH), which also correlates with outcome, is a likely surrogate for tumor volume.
Metastatic disease
After administration of preoperative chemotherapy, factors that influence outcome include the following:
- Surgical resectability.
- Degree of tumor necrosis.
In general, prognostic factors in osteosarcoma have not been helpful in identifying patients who might benefit from treatment intensification or who might require less therapy while maintaining an excellent outcome.