Height as a risk factor in osteosarcoma

Abstract

9042 Background: The highest incidence of osteosarcoma in dogs of large breed suggested that height can play a role in the pathogenesis of this human bone sarcoma typical of childhood and adolescence Methods: A continuous series of 962 patients (560 males and 402 females) with bone osteosarcoma treated at the same institution between 1981 and 2001 were evaluated. 836 had localized disease, whereas 126 were metastatic at diagnosis. The median age at diagnosis was 16.1 years (2.5–60) with a peak at 12.5 years in females (mean 18.9+/-9) and 15 years in males (mean 17.1+/-8.9). All patients underwent surgery and chemotherapy. The following data were retrieved: age, height and pubertal stage at diagnosis, stage of disease, site, chemotherapy protocol. Our patients were subdivided into 4 groups according to age (Table). Heights of this series were compared with the standard of the national population matched for gender, age, and geographic area of origin and secular trend. Heights were expressed as standard deviation scores (SDS). Results: At diagnosis, a high percentage of patients of Groups 1, 2, and 3 were found to be above the 50th percentile for height of the reference population, and their mean SDS height value was significantly higher than the mean SDS Final Height value, as measured at the end of puberty (p<0.0001), both in males and females. On the contrary, the height of patients with osteosarcoma in adulthood did not significantly differ from that of the reference population. Conclusions: The higher incidence during the pubertal spurt, in the anatomic sites of greater growth and in taller individuals, suggests that the GH-IGF axis may play a role in the pathogenesis of osteosarcoma, in agreement with a number of previous experimental studies. The finding that final height of osteosarcoma patients does not differ from that of the standard reference population may reflect the detrimental influence of aggressive multiagent chemotherapy on osteogenesis. No significant financial relationships to disclose.