Suboptimal chemotherapy is an adverse prognostic factor in osteosarcoma

Background: We sought to determine whether suboptimal chemotherapy compromised the prognosis ofosteosarcoma patients. Methods: A total of 132 eligible patients who underwent chemotherapy between 1998 and 2008 wereidentified in our database. Information regarding patient demographics, clinicalcharacteristics, and survival status were extracted for analysis. Optimal chemotherapy wasdefined as receipt of [greater than or equal to]80% of the planned dose intensity of prescribed agents within theplanned durations Results: The use of optimal chemotherapy resulted in an overall survival benefit with P = 0.006.Patients who failed to complete the optimal chemotherapy protocol had a dismal prognosis of30.8% overall survival over five years, whereas those who completed the optimalchemotherapy had an overall survival rate over five years of 65.3%. Based on multivariateanalysis, patients who were treated with a suboptimal protocol had a higher risk of relapse,metastasis and mortality. The hazard ratio (HR) of recurrence or death for the suboptimalchemotherapy group was as high as 2.512 over that of the optimal chemotherapy group (HR= 2.512, 95% confidence interval = 1.242 to 3.729). Conclusions: Chemotherapy is a significant independent prognostic variable, and suboptimal chemotherapywas found to have a detrimental effect on the outcome of patients with osteosarcoma.

via World Journal of Surgical Oncology