Table IV.
Five-year survival rate and univariate analysis in patients with osteosarcoma <25 years of age between 1973 and 2012.
| Univariate analysis | ||||
|---|---|---|---|---|
| Variables | n (%) | Survival (95% CI) | HR (95% CI) | P-value |
| Year of diagnosis | aP<0.001 | |||
| 1973–1982 | 357 (11.6) | 50.1 (45.0–55.2) | Reference | |
| 1983–1992 | 404 (13.1) | 62.7 (58.0–67.4) | 0.701 (0.576–0.852) | aP<0.001 |
| 1993–2002 | 851 (27.6) | 63.5 (60.2–66.8) | 0.661 (0.557–0.784) | aP<0.001 |
| 2003–2012 | 1,473 (47.7) | 66.3 (63.6–69.0) | 0.582 (0.493–0.687) | aP<0.001 |
| Sex | aP<0.001 | |||
| Male | 1,757 (57.0) | 60.1 (57.7–62.5) | Reference | |
| Female | 1,328 (43.0) | 67.3 (64.8–69.8) | 0.757 (0.675–0.849) | aP<0.001 |
| Age at diagnosis (years) | a0.014 | |||
| 0–4 | 49 (1.6) | 54.1 (39.2–69.0) | Reference | |
| 5–9 | 368 (11.9) | 64.2 (59.1–69.3) | 0.728 (0.468–1.131) | 0.158 |
| 10–14 | 1,064 (34.5) | 66.4 (63.5–69.3) | 0.666 (0.437–1.014) | 0.058 |
| 15–19 | 1,102 (35.7) | 60.0 (57.1–62.9) | 0.828 (0.545–1.258) | 0.376 |
| 20–24 | 502 (16.3) | 63.8 (59.5–68.1) | 0.776 (0.504–1.194) | 0.249 |
| Race | 0.939 | |||
| Caucasian | 2,289 (74.2) | 63.2 (61.0–65.4) | Reference | |
| African descent | 476 (15.4) | 62.1 (57.6–66.6) | 1.023 (0.877–1.194) | 0.771 |
| Other | 296 (9.6) | 62.6 (56.9–68.3) | 0.985 (0.814–1.191) | 0.872 |
| CHSDA region | a0.011 | |||
| East | 843 (27.3) | 65.8 (62.5–69.1) | Reference | |
| Northern Plains | 479 (15.5) | 61.8 (57.3–66.3) | 1.169 (0.981–1.394) | 0.081 |
| Pacific Coast | 1,465 (47.5) | 63.4 (60.9–65.9) | 1.114 (0.970–1.280) | 0.127 |
| Southwest | 295 (9.6) | 56.5 (50.6–62.4) | 1.394 (1.142–1.701) | a0.001 |
| Rural or urban | 0.098 | |||
| Rural | 264 (8.6) | 60.8 (54.7–66.9) | Reference | |
| Urban | 2,758 (89.4) | 63.5 (61.5–65.5) | 0.852 (0.704–1.031) | 0.098 |
| Stage | aP<0.001 | |||
| Localized | 1,034 (33.5) | 77.5 (74.8–80.2) | Reference | |
| Regional | 1,305 (42.3) | 64.7 (62.0–67.4) | 1.640 (1.416–1.900) | aP<0.001 |
| Distant | 562 (18.2) | 31.1 (27.0–35.2) | 4.442 (3.798–5.196) | aP<0.001 |
| Grade | aP<0.001 | |||
| Well | 86 (2.8) | 81.1 (72.5–89.7) | Reference | |
| Moderately | 125 (4.1) | 78.0 (70.4–85.6) | 1.142 (0.653–1.997) | 0.641 |
| Poorly | 524 (17.0) | 61.4 (56.9–65.9) | 2.073 (1.307–3.287) | a0.002 |
| Undifferentiated | 1,100 (35.7) | 64.5 (61.6–67.4) | 2.015 (1.286–3.163) | a0.002 |
| Tumor size (mm) | aP<0.001 | |||
| <50 | 127 (4.1) | 79.5 (71.7–87.3) | Reference | |
| 50–99 | 458 (14.8) | 73.2 (68.7–77.7) | 1.250 (0.809–1.930) | 0.315 |
| 100–119 | 149 (4.8) | 64.3 (55.9–72.7) | 1.751 (1.082–2.836) | a0.023 |
| ≥120 | 340 (11.0) | 56.4 (49.9–62.9) | 2.119 (1.376–3.263) | a0.001 |
| Laterality | 0.371 | |||
| Right | 1,364 (44.2) | 50.0 (47.5–52.5) | Reference | |
| Left | 1,367 (44.3) | 63.3 (60.6–66.0) | 1.056 (0.937–1.191) | 0.371 |
| Histologic Type ICD-O-3 | aP<0.001 | |||
| Osteosarcoma, NOS | 2,223 (72.1) | 60.8 (58.6–63.0) | Reference | |
| Chondroblastic | 407 (13.2) | 62.4 (57.5–67.3) | 0.912 (0.770–1.080) | 0.286 |
| Fibroblastic | 122 (4.0) | 69.9 (61.7–78.1) | 0.732 (0.539–0.994) | a0.045 |
| Telangiectatic | 109 (3.5) | 70.2 (61.0–79.4) | 0.774 (0.557–1.075) | 0.127 |
| Parosteal | 111 (3.6) | 89.0 (82.9–95.1) | 0.287 (0.180–0.457) | aP<0.001 |
| Primary site-labeled | aP<0.001 | |||
| Upper limb | 378 (12.3) | 56.8 (51.5–62.1) | Reference | |
| Lower limb | 2,321 (75.2) | 66.4 (64.4–68.3) | 0.737 (0.627–0.867) | aP<0.001 |
| Skull and mandible | 155 (5.0) | 67.6 (60.0–75.2) | 0.694 (0.511–0.944) | a0.02 |
| Vertebral and chest bones | 79 (2.6) | 48.2 (37.0–59.4) | 1.301 (0.943–1.795) | 0.109 |
| Pelvic bones | 135 (4.4) | 31.1 (22.9–39.3) | 2.339 (1.827–2.993) | aP<0.001 |
| Surgery | aP<0.001 | |||
| Yes | 2,613 (84.7) | 66.3 (64.3–68.3) | Reference | |
| No | 399 (12.9) | 44.6 (39.5–49.7) | 2.113 (1.831–2.438) | aP<0.001 |
| Surgery type | aP<0.001 | |||
| No surgery | 244 (7.9) | 42.4 (35.9–48.9) | Reference | |
| Local excision | 208 (6.7) | 75.3 (69.2–81.4) | 0.310 (0.226–0.426) | aP<0.001 |
| Radical excision | 1,076 (34.9) | 71.1 (68.2–74.0) | 0.344 (0.281–0.422) | aP<0.001 |
| Amputation | 389 (12.6) | 61.7 (56.6–66.8) | 0.494 (0.391–0.624) | aP<0.001 |
| Radiation | aP<0.001 | |||
| Yes | 163 (5.3) | 35.3 (27.7–42.9) | Reference | |
| No | 2,881 (93.4) | 64.8 (63.0–66.6) | 0.373 (0.308–0.450) | aP<0.001 |
a
Statistically significant. P<0.05 was considered to indicate statistically significant difference. P-values calculated by univariate analysis. HR, hazard ratio; CI, confidence interval; n, number; ICD, International Classification of Disease; NOS, not otherwise specified; CHSDA, Contract Health Service Delivery Areas.