Prognosis and survival for childhood osteosarcoma

The following are prognostic and predictive factors for childhood osteosarcoma.

Metastasis is when cancer spreads from where it started to another part of the body. Whether or not the cancer has already spread when it is first diagnosed is the most important prognostic factor for childhood osteosarcoma. Metastasis is linked with a poorer prognosis.

Osteosarcoma that has only spread to a lung has a more favourable prognosis than osteosarcoma that has spread to other bones.

Tumours farther from the centre of the body have a better prognosis than tumours closer to the centre of the body. This may be because tumours farther from the centre of the body are usually easier to remove surgically.

Tumours in the upper arms or upper legs have a better prognosis than tumours in the pelvis or spine. Tumours in the pelvis or spine tend to have the poorest prognosis. They are often detected late and are often closer to other important organs, which makes them hard to completely remove.

Larger tumours appear to have a poorer prognosis than smaller tumours.

Chemotherapy is usually given before surgery to shrink the tumour and make surgery easier. This is called neoadjuvant chemotherapy. Osteosarcoma that responds well to neoadjuvant chemotherapy (more than 90% of the tumour cells are killed) has a better prognosis than osteosarcoma that does not respond to neoadjuvant chemotherapy.

Tumours that can be completely removed have a better prognosis than tumours that can't be completely removed.

Tumours that cause breaks (fractures) in the bone have a poorer prognosis than tumours that have not led to broken bones.