Cyclooxygenase-2 overexpression predicts poor survival in patients with high-grade extremity osteosarcoma: a pilot study.

Abstract

UNLABELLED:

Several lines of evidence suggest cyclooxygenase-2 (COX-2) overexpression may be a causal factor for tumor growth and metastasis. However, there is no evidence COX-2 expression in a primary tumor correlates with clinical outcome of osteosarcoma. We examined expression levels of COX-2 immunohistochemically in 51 patients with extremity osteosarcoma who completed standard therapy and obtained complete initial regression of the tumor. Correlation of the positivity of staining with prognosis was analyzed. COX-2 was expressed in most of the cases. We found no correlation between COX-2 staining intensity and variables such as gender, age, anatomic site, necrosis after chemotherapy, and surgical stage. Strong COX-2 expression was associated with low metastasis-free survival. Age older than 20 years and strong COX-2 expression independently predicted increased risk of metastasis. Among seven patients with resectable lung metastasis, all three with greater COX-2 expression in the metastatic lesion than that in a primary site died of the disease. Our preliminary data suggest COX-2 overexpression in the primary tumor correlates with the occurrence of distant metastasis in patients with osteosarcoma and also may affect postmetastatic survival.

LEVEL OF EVIDENCE:

Level IV, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

• Authors: Hiroshi Urakawa, Yoshihiro Nishida, Takahiro Naruse, Hiroatsu Nakashima, Naoki Ishiguro
• Journal: Clinical orthopaedics and related research (Clin Orthop Relat Res) Vol. 467 Issue 11 Pg. 2932-8 (Nov 2009) ISSN: 1528-1132 [Electronic] United States
• PMID: 19326179 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Cyclooxygenase 2

Topics

• Adolescent
• Adult
• Biomarkers, Tumor (blood)
• Bone Neoplasms (mortality, pathology, therapy)
• Chemotherapy, Adjuvant
• Chi-Square Distribution
• Child
• Child, Preschool
• Cohort Studies
• Combined Modality Therapy
• Confidence Intervals
• Cyclooxygenase 2 (blood)
• Disease-Free Survival
• Female
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Neoplasm Invasiveness (pathology)
• Neoplasm Staging
• Osteosarcoma (mortality, pathology, therapy)
• Pilot Projects
• Predictive Value of Tests
• Probability
• Prognosis
• Proportional Hazards Models
• Risk Assessment
• Survival Analysis
• Treatment Outcome
• Upper Extremity
• Young Adult