Abstract
Objective: To present a series of 50 consecutive patients with non-metastatic extremity osteosarcoma, and attempt to correlate expression of the vascular endothelial growth factor (VEGF) protein in biopsy tissue to their prognosis regarding overall survival, disease-free survival and local recurrence. Methods: Fifty cases of non-metastatic osteosarcoma of the extremities treated between 1986 and 2006 at Instituto de Ortopedia e Traumatologia da Universidade de São Paulo, São Paulo, Brasil, were evaluated regarding expression of the VEGF protein. There were 19 females and 31 males. The mean age was 16 years old (range 5-28 years old) and the mean follow-up was 60.6 months (range 25-167 months). The variables studied were age, gender, anatomic location, type of surgery, surgical margins, tumor size, post chemotherapy necrosis, local recurrence, pulmonary metastasis and death. Results: Thirty-six patients showed VEGF expression on 30% or less cells (low), and the remaining 14 cases had VEGF expression above 30% (high). Among the 36 patients with low VEGF expression, nine developed pulmonary metastasis and four died (11.1%). Among the 14 patients with high VEGF expression, six developed pulmonary metastasis and three died (21.4%). Conclusion: There was no statistically significant correlation between the expression of VEGF and any of the variables studied. Level of Evidence IV, Therapeutic Study.
Highlights
Osteosarcoma treatment changed dramatically in the 80’s with the use of multiagent chemotherapy
Lots of papers confirmed the excellent results of mutiagent chemotherapy, which usually included high-dose methotrexate and doxorubicin, and the 5-year survival rates jumped from 15% to around 70% in nonmetastatic patients
The objective of this study is to present a series of 50 consecutive nonmetastatic extremity osteosarcoma patients, and try to correlate the vascular endothelial growth factor (VEGF) expression in their biopsy tissue to their prognosis regarding overall survival, disease-free survival and local recurrence
Summary
Osteosarcoma treatment changed dramatically in the 80’s with the use of multiagent chemotherapy. Osteosarcoma patients were treated only with limb amputation, when feasible, and experienced a survival rate around 15%. Stimulated by the brilliant results, preoperative chemotherapy was suggested in order to try to preserve the affected limb.[1] Lots of papers confirmed the excellent results of mutiagent chemotherapy, which usually included high-dose methotrexate and doxorubicin, and the 5-year survival rates jumped from 15% to around 70% in nonmetastatic patients. With that situation in mind, other paths are being tried in order to advance in the osteosarcoma survival rates. In 1999, Lee et al.[2] were the first to try to establish VEGF expression as a prognostic factor for survival in osteosarcoma patients. The objective of this study is to present a series of 50 consecutive nonmetastatic extremity osteosarcoma patients, and try to correlate the VEGF expression in their biopsy tissue to their prognosis regarding overall survival, disease-free survival and local recurrence
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