Formulation and validation of a baseline prognostic score for osteosarcoma treated uniformly with a non-high dose methotrexate-based protocol from a low middle income healthcare setting: a single centre analysis of 594 patients

• DOI: 10.3389/fonc.2023.1148480
• Publication Date: 2023-04-28T05:58:37Z
• Authors: Shuvadeep Ganguly; Archana Sasi; Shah Alam Khan; Venkatesan Sampat...; Love Kapoor; Mehar Chand Sharma; Asit Mridha; Adarsh Barwad; Sanjay Thulkar; Deepam Pushpam; Sameer Bakhshi
• Keywords: Oncology; osteosarcoma; score; bone sarcoma; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; low middle income countries; prognostic; RC254-282; 3. Good health

The outcomes of osteosarcoma in low middle income countries (LMICs) are different due to patients presenting advanced stages, resource constraints and the use non-high-dose-methotrexate (HDMTX)-based regimens. This study derived validated a prognostic score for that integrates biologic social factors is tailored from an LMIC setting using non-HDMTX-based protocol.A retrospective including enrolled treatment at single tertiary care centre India between 2003-19 was conducted. Baseline characteristics were extracted medical records survival noted. cohort randomised into derivation validation cohort. Multivariable Cox regression used identify baseline independently A identified further with estimation its predictive ability.594 eligible inclusion study. Around one-third had metastatic disease 59% residing rural areas. presence metastases (HR 3.39; p<0.001; score=3), elevated serum alkaline phosphatase (SAP) >450 IU/L 1.57; p=0.001; score=1) tumour size > 10 cm 1.68; be independent predicting inferior event free (EFS) included development score. Patients categorized as risk (score 0), intermediate 1-3) high (4-5). Harrell's c-indices 0.682, 0.608 0.657 respectively EFS derivation, whole respectively. timed AUC ROC 0.67 18-month cohorts while 36-month 0.68, 0.66 0.68 respectively.The describes among treated uniformly protocol. Tumor size, SAP derive good value outcomes. Social did not emerge determinants survival.