Model of Ferrari et al for Predicting Survival After Relapse With Lung Metastases in Osteosarcoma of the Extremities

Description

Ferrari et al developed a model for predicting survival in patients with recurrence of osteosarcoma in an extremity and pulmonary metastases. This can help identify those patients who may be candidates for novel therapies. The authors are from Bologna, Ravenna and Torino in Italy.

Criteria:

(1) recurrent osteosarcoma in an extremity

(2) presence of lung metastases

(3) complete resection of extremity recurrence and lung metastases (complete surgery)

Parameters for prognostic model:

(1) relapse free interval in months

(2) number of lung metastases

Relapse Free Interval	Number of Lung Metastases	Prognostic Group
> 24 months	1 or 2	A (good)
<= 24 months	1 to 2	B (fair)
> 24 months	>= 3	C (poor)
<= 24 months	> =3	D (very poor)

from Figure 1, page 713

Prognostic Group	Median Survival in Months	Percent 8 Year Survival
A (good)	> 120 months	55%
B (fair)	36 months	30%
C (poor)	24 months	15%
D (very poor)	12 months	2%

from Figure 1, page 713

Other management issues:

(1) If the recurrence was unresectable, then patients benefit from second line chemotherapy (postrelapse survival at 12 months 53% vs 12% without chemotherapy).

(2) The authors did not find that generalized use of chemotherapy was beneficial after complete surgery of the first recurrence.

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Description

Specialty

ICD-10