Objective: Various response assessment criteria are available for osteosarcoma which include clinical, radiological and histological parameters. In this study we analyzed if clinical assessment used for response assessment can predict prognosis in patients receiving neoadjuvant chemotherapy for extremity osteosarcoma.
Methods: Retrospective analysis of a prospectively maintained database between 2008 and 2018 was performed. Patients with clinical progression during neoadjuvant chemotherapy for extremity osteosarcoma (n=41 of 398) were included in this study.
Results: Progression was seen in 41 (10%) of the 398 treated patients. There were 30 male and 11 female patients with a mean age of 18 years. Femur was the commonest site (n=21). 6 patients who were metastatic at presentation progressed. 4 patients had pathological fracture at presentation. All patients underwent surgery of whom 16 were operated post 1 st /2 nd cycle of chemotherapy. Amputation was done in 35 patients whilst limb was salvaged in 6. Twelve patients had recurrence. Median follow up was 19 months.8 had died. The median OS was significantly lower in patients with progression on chemotherapy than those who did not progress (35±16 months Vs 72± 13 months, p<0.035).
Conclusion: Clinical assessment for progression in patients receiving NACT for osteosarcoma is an independent predictor of poor prognosis.
