PLoS ONE (Jan 2013)

Prognostic value of histological response to chemotherapy in osteosarcoma patients receiving tumor-bearing frozen autograft.

  • Shinji Miwa,
  • Akihiko Takeuchi,
  • Hiroko Ikeda,
  • Toshiharu Shirai,
  • Norio Yamamoto,
  • Hideji Nishida,
  • Katsuhiro Hayashi,
  • Yoshikazu Tanzawa,
  • Hiroaki Kimura,
  • Kentaro Igarashi,
  • Hiroyuki Tsuchiya

DOI
https://doi.org/10.1371/journal.pone.0071362
Journal volume & issue
Vol. 8, no. 8
p. e71362

Abstract

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BackgroundA variety of surgical procedures are now available for tissue reconstruction after osteosarcoma excision, and an important prognostic factor is the evaluation of response to chemotherapy using histology. Although tumor-bearing autografts are useful tools for reconstruction, re-use of the primary tumor may make it difficult to assess the histological response to chemotherapy, since the entire tumor cannot be analyzed. Here, we analyzed the prognostic value of the histological response in the patients who received frozen tumor-bearing autografts for reconstruction.MethodRetrospective analysis of the medical records of 51 patients with high-grade osteosarcoma of the extremities was performed. All patients received reconstruction using frozen tumor-bearing autografts. Tumor necrosis was evaluated in extraskeletal masses and cancellous bone.ResultsFive-year overall survival of patients with good and poor response to chemotherapy was 82.9% and 46.4%, respectively (P = 0.044), and 5-year event-free survival was 57.7% and 36.0%, respectively (P = 0.329). Multivariate analysis revealed that a poor histological response to chemotherapy was a significant prognostic factor for overall survival (P = 0.033).ConclusionHistological response is an important and reliable prognostic factor in patients undergoing reconstruction using frozen tumor-bearing autografts.