Patients with osteosarcoma (OS) which has spread to the lungs (lung metastasised osteosaroma, or LMOS) have poor survival rates.
Nomograms are a form of predictive technology used in medicine. They are particularl3
This randomized control trial looked at risk factors of LMOS. This was so the doctors would be able to better support those with OS. They did this by looking at existing population trends of child and young adulthood patients who had LMOS when they were diagnosed.
How did the researchers do this?
The researchers used data from the National Institute of Cancer’s Surveillance, Epidemiology, and End Results (SEER) database. This is a large database in the USA which has information on cancer in the USA population. It provides rich information and insights into cancer at a population level. This means information from the SEER database can be used to help predict cancer treatment outcomes.
The following information was extracted from the database for child and young adult OS patients, including:
- Year of diagnosis
- Age at diagnosis
- Race
- Gender
- Primary site (the first place in the body the cancer was located)
- Size of tumour
- Any metastasised locations (if or where the cancer has spread to. This includes LMOS)
The researchers used this information to calculate a ‘cancer specific survival’ rate. This was defined as the time from diagnosis of osteosarcoma to the death because of osteosarcoma. Patients whose death was from other conditions were excluded from the study.
What did the researchers find?
The researchers found the following were risk factors for LMOS occurrence:
- Larger tumour size
- Higher tumour grade (how unusual the cancer cells look. This is compared to healthy cells. More unusual cells indicate a higher grade)
- CancerA disease where cells divide and grow uncontrollably and can spread to other areas of the body. which had spread from its original site (metastasised)
- Cancer specific survival was around 25 months
The worst survival outcomes were found for male patients, age 20-39 years, who had cancer which had metastasised. This group of patients also had the highest risk of developing lung metastasis.
Surgery appeared to be a factor which helped protect against the poor survival rates. Radiotherapy did not affect cancer specific survival.
Rates of OS increased in the age group of male aged 10-19 years between the years of 2010-2019. This makes sense as OS is found the most commonly in young males.
How can this help OS patients?
This study aimed to use population level information on OS in the USA to create a predictive model (a nomogram) which could help predict outcomes of OS patients. The model showed results which can be applied to population level as well as identifying risk factors for developing LMOS. It also identified surgery as a treatment that helped protect against LMOS.
Nomograms are used in healthcare and can help personalise treatment. This nomogram could help improve outcomes for those with OS by tailoring treatment to each patient. Population level data helps see patterns in treatments for different patient groups. They could also be helpful to improve the poor outcomes of those with OS.
References:
Balachandran VP, Gonen M, Smith JJ, DeMatteo RP. Nomograms in oncology: more than meets the eye. Lancet Oncol. 2015 Apr;16(4):e173-80. doi: 10.1016/S1470-2045(14)71116-7. PMID: 25846097; PMCID: PMC4465353.
Liu T, Cui L, He Z, Chen Z, Tao H, Yang J. Epidemiology and nomogram of pediatric and young adulthood osteosarcoma patients with synchronous lung metastasis: A SEER analysis. PLoS One. 2023 Jul 12;18(7):e0288492. doi: 10.1371/journal.pone.0288492. PMID: 37437020; PMCID: PMC10337906.