Dissertation
Dissertation > Medicine, health > Oncology > Sports Department tumor > Bone tumor

Analysis of the Influence Factors of Survival Time in Patients with Osteosarcoma

Author DongLiFei
Tutor ZhangGuoChuan
School Hebei Medical University
Course Surgery
Keywords Osteosarcoma Survival Time Prognosis Affecting Factors Regression Analysis
CLC R738.1
Type Master's thesis
Year 2014
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Objective For part of the relevant factors affecting the prognosis ofpatients with osteosarcoma were analyzed. Osteosarcoma is also called theosteogenesis sarcoma, Most of them are primary,they are the most commonmalignant bone tumors.Slightly different abroad, In the incidence of primarybone tumors they rank only second to plasma cell myeloma. The incidence ofosteosarcoma is about (1-3)/1million,cardinal number of ourcountry population is large,so the actual number of patients with osteosarcomais also large. Currently, the exact cause of osteosarcoma is still unclear,butthere have been many stutys show it has close relationship with geneticfactors, virus infection, radiation damage, chemical carcinogens andLong-term exposure to radionuclides.there are many ways to classifyosteosarcoma. According to the location of osteosarcoma,pathologicaltype,and malignancy, The osteosarcoma is divided into seven kinds. Thetreatment of osteosarcoma from the initial simple surgery to givechemotherapy after surgery,The comprehensive treatment is surgical treatmentwith neoadjuvant chemotherapy at present. Although the five-year survivalrate of patients has been greatly improved., the treatment effect is still notideal.The fatality rate and disability rate of osteosarcoma are still high.Although scholars have discussed the influence factors affecting the prognosisof osteosarcoma,the conclusion is not unified.We once again discuss theinfluence factors of affect the prognosis of osteosarcomain order to guiding clinical practice.Materials and MethodsMaterials: Selecting20cases of complete medical history of patientswith osteosarcoma,(the medical history of whom had been cured or dead), Ofthem13are males and7are females, age8-52, The average age was (17.5±9.6),14cases were under the age of25,6cases were above the age of25,9cases of patients were urban residents,11cases of patients were ruralresidents.16cases,time feeling discomfort to see a doctor were within3months,4cases time were more than3months.The lactic dehydrogenase(LDH)of8cases of patient increased, Thelactic dehydrogenase(LDH)of12cases of patient normal. The Alkaline phosphatase(AKP)of12cases of patientincreased, The Alkaline phosphatase(AKP)of8cases of patient normal.1caseof occurrence location was in upper extremity,16cases were in lowerextremity,3cases were in other sites.13cases of tumour area were Less than50cm2,6cases were between50-100cm2,1was greater than100cm2.5caseswere Classified asⅡ A grade,12cases were Classified asⅡ B grade,3caseswere Classified asⅢ grade,11cases were below70points,9cases werehigher than70points.13cases were performed limb-salvage surgery(3casesrecurred and performed amputation),5cases were performed amputation,2cases were cured by conservative treatment.There are internal transfer in4cases,and no internal transfer in16cases when they first visit to a doctor. Inthe process of treatment,8cases occur pulmonary metastasis,3cases occurlocal recurrence,2cases transfer to other parts.6cases Performedwell,common10,bad4in response to chemotherapy.All patients except2cases of conservative treatment received1~3cycles of preoperativeneoadjuvant chemotherapy.MethodsRecord the data of20cases of patients with osteosarcoma, includingplace of residence, gender, age, the time feeling discomfort to see a doctor,AKP, LDH, the size of the tumor,The size of the tumor,Enneking surgicalstaging, Karnofsky score,Whether proceeding the limb-salvage,Selection ofoperation, there was or no internal transfer when they first visit a doctor,therewere or not internal transfer and recurrence In the process of treatment,thetime occur a transfer,response to chemotherapy and the proportion of tumorsize and the visit time.Analysis all clinical factors mentioned above by singlefactor,select Statistically significant factors and proceed multivariate analysis. 1.3statistical processing: All the data were handleed with SPSS statisticalsoftware package, the Log-Rank test handled Single factor analysis,Statistical significance was found in the single factor analysis of factors intothe Cox proportional hazards regression model for multiple factors analysis,Kaplan Meier method was used for survival analysis and survival curvedrawing. P<0.05difference was statistically significant.ResultsFollow-up results The survival time of20patients was from6monthsto10years(truncation time). The median survival time was24months,Overall survival condition as shown in figure1. three year survival rate was45%,the5-year survival rate was35%, the cure rate was20%.Single factor analysis The log-rank examination showed that theprognosis of patients with osteosarcoma was related to LDH, the tumor site,tumor size, Enneking surgical staging, Karnofsky functional score, operationmethod, internal transfer or not when first to see a doctor andresponse to chemotherapyMultiple factors analysis Research findings showed that Karnofskyfunctional status score (figure2), internal transfer or not when first to see adoctor (figure3) and response to chemotherapy (figure4) wereindependent factors for predicting the prognosis.ConclusionsLDH,tumor site, tumor size, Enneking surgical staging, Karnofskyfunctional status score, operation method, internal transfer or not when first tosee a doctor and response to chemotherapy were the influence factors ofaffecting the prognosis of patients with osteosarcoma, while Karnofskyfunctional status score, internal transfer or not when first to see a doctor, andresponse to chemotherapy were independent factors affecting the prognosis, soearly detection and early treatment, regular chemotherapy and selectingsensitive chemotherapeutic drugs to patients were the key for the treatment ofosteosarcoma.

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