European Journal of Surgical Oncology
Volume 35, Issue 10 , Pages 1030-1036, October 2009

Prognostic factors in localized extremity osteosarcoma: A systematic review

  • J.A.M. Bramer

      Affiliations

    • Department of Orthopedic Surgery (G4 221), Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
    • Corresponding Author InformationCorresponding author. Tel.: +31 20 4723023; fax: +31 20 5669117.
    • ,
  • J.H. van Linge

      Affiliations

    • Department of Orthopedic Surgery, Erasmus Medical Centre, Dr Molewaterplein 50-60, 3015 GE Rotterdam, The Netherlands
    • ,
  • R.J. Grimer

      Affiliations

    • Oncology Service, Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, United Kingdom
    • ,
  • R.J.P.M. Scholten

      Affiliations

    • Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands

Accepted 20 January 2009.

Abstract 

Aim

Finding reliable prognostic factors for osteosarcoma remains problematic. A systematic review [Davis AM, Bell RS, Goodwin PJ. Prognostic factors in osteosarcoma: a critical review. Journal of Clinical Oncology 1994; 12(2): 423–431.] showed chemotherapy response as only independent factor. We tried to identify evidence-based prognostic factors in the literature since 1992 and to establish pooled relative risks of factors.

Methods

MEDLINE and Embase search (1992–August 2006). Two reviewers independently selected papers addressing prognostic factors in localized extremity osteosarcoma, which were studied for methodological quality, and valuable new factors. An attempt was made to pool results.

Results

Of 1777 “hits”, 93 papers were studied in depth. Several “new” prognostic factors were found. Only 7 papers were of sufficient quality to analyze. Chemotherapy response, tumor size and site, alkaline phosphatase level and p-glycoprotein expression seemed to be independent factors. Some new factors looked promising.

Conclusions

Although the literature is abundant, it is disappointing that only few papers are of sufficient quality to allow hard conclusions. Because of heterogeneity of the studies pooling results is hardly possible. There is a need for standardization of studies and reports.

Keywords: Humans, Osteosarcoma, Bone neoplasms, Prognosis, Survival analysis, Extremities

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PII: S0748-7983(09)00028-6

doi:10.1016/j.ejso.2009.01.011

European Journal of Surgical Oncology
Volume 35, Issue 10 , Pages 1030-1036, October 2009

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