Alkaline phosphatase level change in patients with osteosarcoma: Its role as a predictive factor of tumor necrosis and clinical outcome

Johad F. Khoury, Myriam Wey Ben-Arush, Michael Weintraub, Elisha Waldman, Boris Futerman, Eugene Vlodavsky, Sergey Postovsky*

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Scopus citations


Background: In osteosarcoma the histological response, measured by the percentage of tumor necrosis, constitutes one of the most significant predictive factors, with better survival in patients whose tumor necrosis is ≥ 90%. Objectives: To determine if the decrease rate of serum alkaline phosphates (SAP) levels during the first month of neoadjuvant chemotherapy could serve as a predictive indicator of tumor necrosis and clinical outcome. methods: We analyzed the medical fles of 53 osteosarcoma patients (19 females, 34 males) (median age 16 years, range 8-24); the disease was metastatic in 12 and localized in the other 41. results: The histological responses were good in 38 patients (71.7%) and poor in 15 (28.3%). At a median follow-up of 50 months, 34 patients (64.2%) had no evidence of disease and 19 (35.8%) had died from the disease. High levels of SAP at diagnosis correlated with worse survival (P = 0.002). There was no difference in overall survival between patients whose SAP decrease rate was > 25% and those with a rate < 25% (P = 0.14). Among female patients, "rapid" SAP responders had better survival than "slow" responders (P = 0.026). In patients with metastases the SAP decrease rate was positively correlated with survival (P = 0.042). conclusions: There was no evidence that "rapid" SAP re-sponders had a higher percentage of tumor necrosis than "slow" responders, although female "rapid" SAP responders had a better prognosis than "slow" responders. Patients with metastases at presentation and "rapid" SAP response had better prognoses.

Original languageEnglish (US)
Pages (from-to)26-32
Number of pages7
JournalIsrael Medical Association Journal
Issue number1
Publication statusPublished - Jan 1 2014



  • Alkaline phosphatase
  • Necrosis
  • Osteosarcoma
  • Survival

ASJC Scopus subject areas

  • Medicine(all)

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