TY - JOUR
T1 - Alkaline phosphatase level change in patients with osteosarcoma
T2 - Its role as a predictive factor of tumor necrosis and clinical outcome
AU - Khoury, Johad F.
AU - Ben-Arush, Myriam Wey
AU - Weintraub, Michael
AU - Waldman, Elisha
AU - Futerman, Boris
AU - Vlodavsky, Eugene
AU - Postovsky, Sergey
PY - 2014/1
Y1 - 2014/1
N2 - 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.
AB - 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.
KW - Alkaline phosphatase
KW - Necrosis
KW - Osteosarcoma
KW - Survival
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M3 - Article
C2 - 24575501
AN - SCOPUS:84893032081
SN - 1565-1088
VL - 16
SP - 26
EP - 32
JO - Israel medical journal
JF - Israel medical journal
IS - 1
ER -