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A new relative tumor sizing method in epi-metaphyseal osteosarcoma

 Seung Hyun Kim  ;  Kyoo-Ho Shin  ;  Eun Hae Park  ;  Yong Jin Cho  ;  Byoung-Kyu Park  ;  Jin-Suck Suh  ;  Woo-Ick Yang 
 BMC CANCER, Vol.15 : 284, 2015 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Bone Neoplasms/diagnostic imaging* ; Bone Neoplasms/drug therapy* ; Bone Neoplasms/pathology ; Child ; Child, Preschool ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoadjuvant Therapy ; Osteosarcoma/diagnostic imaging* ; Osteosarcoma/drug therapy* ; Osteosarcoma/pathology ; Prognosis ; Radiography ; Retrospective Studies
Osteosarcoma ; Relative tumor sizing ; Tumor axial ratio
BACKGROUND: The goal of this study was to develop a new method for determining tumor size to predict prognosis with high performance in osteosarcoma. METHODS: This study was approved by the institutional review board. We retrospectively reviewed 41 magnetic resonance (MR) images at diagnosis and 57 MR images after neoadjuvant chemotherapy from 59 patients with non-metastatic, high-grade extremity osteosarcoma, who had undergone surgery between October 1994 and October 2009. RESULTS: A new parameter of tumor axial ratio (TAR) was designed to normalize tumor size by dividing the absolute tumor axial size by the reference bone axial size (RBS) of the affected bone. RBS was defined using anatomical landmarks for each type of bone. Absolute tumor length (ATL), absolute tumor volume (ATV), and relative tumor volume (RTV) were comparatively analyzed. TAR was only significantly decreased after chemotherapy in the survival (P = 0.009) and metastasis-free (P = 0.018) group in the paired t-test. With the Kaplan-Meier method, significant differences in overall survival (log rank P = 0.004) and disease-free survival (Log Rank P = 0.009) were noted between decreased TAR after chemotherapy and increased TAR. After Cox regression analysis, TAR showed an odds ratios of 5.931 for survival (95% Confidence Interval [CI], 1.153-30.513) and 14.144 for metastasis (95% CI, 2.826-70.784), whereas ATL, ATV, and RTV showed no associations with these clinical variables. The AUC value of TAR was 0.713 (95% CI, 0.548 to 0.878) for survival and 0.759 (95% CI, 0.608 to 0.909) for metastasis. CONCLUSIONS: TAR is a novel sizing method with potential as a prognostic tool in osteosarcoma.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Suh, Jin Suck(서진석) ORCID logo https://orcid.org/0000-0001-9455-9240
Shin, Kyoo Ho(신규호)
Yang, Woo Ick(양우익) ORCID logo https://orcid.org/0000-0002-6084-5019
Cho, Yong Jin(조용진)
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