Prognostic Factors in Newly Diagnosed High‐Grade Osteosarcoma—A Systematic Review
ABSTRACT Introduction Pretreatment prognostic factors in newly diagnosed osteosarcoma are important for clinical management and stratifying patients in clinical trials. Such factors include the presence of metastases, primary tumor size, and site. Factors surrounded by controversy include pathologic...
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2025-07-01
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| Online Access: | https://doi.org/10.1002/cam4.71044 |
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| author | Elisa Tirtei Sascha Wilk Michelsen Lianne M. Haveman Cristina Meazza Joana F. Oliveira Ayesha Rasool Emanuela Palmerini Will Wilson Nathalie Gaspar Sandra J. Strauss Andri Papakonstantinou Fredrik Baecklund the FOSTER Consortium (Fight OsteoSarcoma Through European Research), work package 4 on trials in newly diagnosed osteosarcoma |
| author_facet | Elisa Tirtei Sascha Wilk Michelsen Lianne M. Haveman Cristina Meazza Joana F. Oliveira Ayesha Rasool Emanuela Palmerini Will Wilson Nathalie Gaspar Sandra J. Strauss Andri Papakonstantinou Fredrik Baecklund the FOSTER Consortium (Fight OsteoSarcoma Through European Research), work package 4 on trials in newly diagnosed osteosarcoma |
| author_sort | Elisa Tirtei |
| collection | DOAJ |
| description | ABSTRACT Introduction Pretreatment prognostic factors in newly diagnosed osteosarcoma are important for clinical management and stratifying patients in clinical trials. Such factors include the presence of metastases, primary tumor size, and site. Factors surrounded by controversy include pathological fracture, histologic subtype, and P‐glycoprotein expression. No prognostic tumor biomarker has been established. We performed a systematic review with the aim to compile available evidence for pretreatment prognostic factors and define optimal cut‐off values for patient stratification or further validation in the upcoming European FOSTER‐CabOS trial. Methods Predefined search terms were used to search PubMed, Web‐of‐science, and Embase for all studies investigating pretreatment prognostic factors in newly diagnosed osteosarcoma patients published 2000–2023. After applying strict inclusion and exclusion criteria, 49 papers were included. Results We found 14 factors investigated in at least two separate studies or in a single study using one discovery and at least one validation cohort. Conclusions We confirmed the prognostic value of patient age, presence of metastasis, tumor size, and site (axial vs. appendicular). Future studies of these factors should focus on specific patient populations and defining optimal cut‐off values. Although serum level of alkaline phosphatase and lactate dehydrogenase were associated with outcome, it remains unclear if they are independent of other prognostic factors. The prognostic value remains unclear for sex, pathological fracture, histologic subtype, and P‐glycoprotein expression. We could not establish any new prognostic biomarker. However, circulating tumor DNA in plasma and the G1/G2 RNA signature in diagnostic tumor biopsies show promise and will be further validated in the upcoming FOSTER‐CabOS trial. |
| format | Article |
| id | doaj-art-5629a5d7a9414cc38ed5cbb9162fec84 |
| institution | DOAJ |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-5629a5d7a9414cc38ed5cbb9162fec842025-08-20T02:48:15ZengWileyCancer Medicine2045-76342025-07-011414n/an/a10.1002/cam4.71044Prognostic Factors in Newly Diagnosed High‐Grade Osteosarcoma—A Systematic ReviewElisa Tirtei0Sascha Wilk Michelsen1Lianne M. Haveman2Cristina Meazza3Joana F. Oliveira4Ayesha Rasool5Emanuela Palmerini6Will Wilson7Nathalie Gaspar8Sandra J. Strauss9Andri Papakonstantinou10Fredrik Baecklund11the FOSTER Consortium (Fight OsteoSarcoma Through European Research), work package 4 on trials in newly diagnosed osteosarcomaDepartment of Pediatric Oncology Regina Margherita Children's Hospital Turin ItalyDepartment of Pediatric and Adolescence Medicine, Clinic for Pediatric Oncology and Hematology University Hospital Rigshospitalet Copenhagen DenmarkPrincess Maxima Center for Pediatric Oncology Utrecht the NetherlandsPediatric Oncology Unit Fondazione IRCCS Istituto Nazionale dei Tumori Milan ItalyPediatric Department Portuguese Institute of Oncology of Lisbon Lisbon PortugalUCL Cancer Institute London UKOsteoncology, Bone and Soft Tissue Tumors and Innovative Therapies IRCCS Istituto Ortopedico Rizzoli Bologna ItalyCancer Research UK and UCL Cancer Trials Centre London UKDepartment of Oncology for Child and Adolescent Gustave Roussy Cancer Campus Villejuif FranceDepartment of Oncology UCL Cancer Institute London UKDepartment of Oncology‐Pathology Karolinska Institutet Stockholm SwedenPediatric Oncology Karolinska University Hospital Stockholm SwedenABSTRACT Introduction Pretreatment prognostic factors in newly diagnosed osteosarcoma are important for clinical management and stratifying patients in clinical trials. Such factors include the presence of metastases, primary tumor size, and site. Factors surrounded by controversy include pathological fracture, histologic subtype, and P‐glycoprotein expression. No prognostic tumor biomarker has been established. We performed a systematic review with the aim to compile available evidence for pretreatment prognostic factors and define optimal cut‐off values for patient stratification or further validation in the upcoming European FOSTER‐CabOS trial. Methods Predefined search terms were used to search PubMed, Web‐of‐science, and Embase for all studies investigating pretreatment prognostic factors in newly diagnosed osteosarcoma patients published 2000–2023. After applying strict inclusion and exclusion criteria, 49 papers were included. Results We found 14 factors investigated in at least two separate studies or in a single study using one discovery and at least one validation cohort. Conclusions We confirmed the prognostic value of patient age, presence of metastasis, tumor size, and site (axial vs. appendicular). Future studies of these factors should focus on specific patient populations and defining optimal cut‐off values. Although serum level of alkaline phosphatase and lactate dehydrogenase were associated with outcome, it remains unclear if they are independent of other prognostic factors. The prognostic value remains unclear for sex, pathological fracture, histologic subtype, and P‐glycoprotein expression. We could not establish any new prognostic biomarker. However, circulating tumor DNA in plasma and the G1/G2 RNA signature in diagnostic tumor biopsies show promise and will be further validated in the upcoming FOSTER‐CabOS trial.https://doi.org/10.1002/cam4.71044newly diagnosedosteosarcomapretreatmentprognostic factorssystematic review |
| spellingShingle | Elisa Tirtei Sascha Wilk Michelsen Lianne M. Haveman Cristina Meazza Joana F. Oliveira Ayesha Rasool Emanuela Palmerini Will Wilson Nathalie Gaspar Sandra J. Strauss Andri Papakonstantinou Fredrik Baecklund the FOSTER Consortium (Fight OsteoSarcoma Through European Research), work package 4 on trials in newly diagnosed osteosarcoma Prognostic Factors in Newly Diagnosed High‐Grade Osteosarcoma—A Systematic Review Cancer Medicine newly diagnosed osteosarcoma pretreatment prognostic factors systematic review |
| title | Prognostic Factors in Newly Diagnosed High‐Grade Osteosarcoma—A Systematic Review |
| title_full | Prognostic Factors in Newly Diagnosed High‐Grade Osteosarcoma—A Systematic Review |
| title_fullStr | Prognostic Factors in Newly Diagnosed High‐Grade Osteosarcoma—A Systematic Review |
| title_full_unstemmed | Prognostic Factors in Newly Diagnosed High‐Grade Osteosarcoma—A Systematic Review |
| title_short | Prognostic Factors in Newly Diagnosed High‐Grade Osteosarcoma—A Systematic Review |
| title_sort | prognostic factors in newly diagnosed high grade osteosarcoma a systematic review |
| topic | newly diagnosed osteosarcoma pretreatment prognostic factors systematic review |
| url | https://doi.org/10.1002/cam4.71044 |
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