70. Survival analysis of patients with metastatic osteosarcoma: a surveillance, epidemiology, and end results population-based study

• Published in: The spine journal 2024-09, Vol.24 (9), p.S37-S38
• Main Author: Lin, Kaiyuan
• Format: Article
• Language: English
• ISSN: 1529-9430
• DOI: 10.1016/j.spinee.2024.06.513

The present study is aimed at investigating whether (1) primary tumor surgery confers an improved survival on patients with metastatic osteosarcoma and (2) primary tumor surgery influences survival of patients with metastatic osteosarcoma differently according to primary tumor site. This study aims to determine whether (1) primary tumor surgery enhances survival in patients with metastatic osteosarcoma and (2) the impact of primary tumor surgery on survival varies by the tumor's primary site. We conducted a retrospective analysis of 517 patients with high-grade metastatic osteosarcoma from the Surveillance, Epidemiology, and End Results (SEER) database, covering the period from 1994 to 2013. Kaplan-Meier analyses, log-rank tests, and multivariate Cox proportional hazard regression models were used to evaluate the survival impact of primary tumor surgery. Among the 517 patients, 351 (68%) underwent primary tumor surgery, while 166 (32%) did not. Primary tumor surgery was linked to significantly improved overall survival (hazard ratio [HR] = 0.457, 95% CI 0.354-0.590, p < 0.001) and cancer-specific survival (HR = 0.422, 95% CI 0.325-0.550, p < 0.001). When analyzing different primary tumor sites, surgery significantly increased survival in patients with extremity osteosarcoma (p < 0.05 for both overall and cancer-specific survival). However, for patients with pelvis/spine osteosarcoma, both univariate and multivariate analyses suggested that primary tumor surgery did not significantly improve survival (p > 0.05 for both overall and cancer-specific survival). This population-based study is the first to demonstrate a positive prognostic impact of primary tumor surgery in patients with metastatic extremity osteosarcoma, but not in those with metastatic axial (pelvis/spine) osteosarcoma. Additionally, the type of surgery (primary tumor resection without amputation versus amputation) did not affect survival outcomes in metastatic osteosarcoma patients. This abstract does not discuss or include any applicable devices or drugs.