Prognostic factors and outcomes for osteosarcoma: An international collaboration

Emilios E. Pakos, Andreas D. Nearchou, Robert J. Grimer, Haris D. Koumoullis, Adesegun Abudu, Jos A.M. Bramer, Lee M. Jeys, Alessandro Franchi, Guido Scoccianti, Domenico Campanacci, Rodolfo Capanna, Jorge Aparicio, Marie Dominique Tabone, Gerold Holzer, Fashid Abdolvahab, Philipp Funovics, Martin Dominkus, Inci Ilhan, Su G. Berrak, Ana Patino-GarciaLuis Sierrasesumaga, Mikel San-Julian, Moira Garraus, Antonio Sergio Petrilli, Reynaldo Jesus Garcia Filho, Carla Renata Pacheco Donato Macedo, Maria Teresa de Seixas Alves, Sven Seiwerth, Rajaram Nagarajan, Timothy P. Cripe, John P.A. Ioannidis

Research output: Contribution to journalArticlepeer-review

150 Scopus citations


We aimed to evaluate the prognostic significance of traditional clinical predictors in osteosarcoma through an international collaboration of 10 teams of investigators (2680 patients) who participated. In multivariate models the mortality risk increased with older age, presence of metastatic disease at diagnosis, development of local recurrence when the patient was first seen, use of amputation instead of limb salvage/wide resection, employment of unusual treatments, use of chemotherapeutic regimens other than anthracycline and platinum and use of methotrexate. It was also influenced by the site of the tumour. The risk of metastasis increased when metastatic disease was present at the time the patient was first seen and also increased with use of amputation or unusual treatment combinations or chemotherapy regimens not including anthracycline and platinum. Local recurrence risk was higher in older patients, in those who had local recurrence when first seen and when no anthracycline and platinum were used in chemotherapy. Results were similar when limited to patients seen after 1990 and treated with surgery plus combination chemotherapy. This large-scale international collaboration identifies strong predictors of major clinical outcomes in osteosarcoma.

Original languageEnglish (US)
Pages (from-to)2367-2375
Number of pages9
JournalEuropean Journal of Cancer
Issue number13
StatePublished - Sep 2009
Externally publishedYes


  • Clinical predictors
  • International collaboration
  • Metastasis
  • Osteosarcoma
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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