What is the prognosis of osteosarcoma?

Updated: Dec 04, 2018
  • Author: Charles T Mehlman, DO, MPH; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Answer

Bu et al conducted a meta-analysis of eight published studies to determine whether p16(INK4a) is a prognostic factor for patients with osteosarcoma. [20]  The meta-analysis showed that a high level of expression of p16(INK4a) was significantly associated with favorable overall survival. The investigators concluded that p16(INK4a) is an effective biomarker of survival for patients with osteosarcoma.

Ma et al conducted a study to determine the diagnostic and prognostic value of circulating miR-148a in the peripheral blood of patients with osteosarcoma. [21]  Expression of miR-148a was significantly associated with tumor size and distant metastasis. High expression of miR-148a was associated with poor overall survival and poor disease-specific survival. The investigators concluded that detection of circulating miR-148a expression in the peripheral blood is useful in identifying patients with osteosarcoma who have a poor prognosis.

A study by Zhao et al found that high expression of the oncoprotein transient receptor potential melastatin member 8 (TRPM8) was predictive of a poor prognosis in patients with osteosarcoma, in that it was associated with higher clinical stage and distant metastasis, as well as with shorter overall survival and disease-free survival. [22]  TRPM8 may prove to be a useful molecular target for therapy in osteosarcoma patients.

Clinical staging as it relates to prognosis is discussed elsewhere (see Staging).

In a retrospective study by Kim et al, the records of 331 patients with stage II osteosarcoma who had undergone surgery and chemotherapy were reviewed. [23]  The authors found that initial tumor size appears to be associated with histologic response and is an important prognostic factor in osteosarcoma. Other studies have shown that patients in whom a good histopathologic response to neoadjuvant chemotherapy has been achieved (>95% tumor cell kill or necrosis) have a better prognosis than those whose tumors do not respond as favorably.


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