Radiological Assessment and Outcome of Local Disease Progression after Neoadjuvant Chemotherapy in Children and Adolescents with Localized Osteosarcoma
Objective: We examined the interobserver reliability of local progressive disease (L-PD) determination using two major radiological response evaluation criteria systems (Response evaluation Criteria in Solid Tumors (RECIST) and the European and American Osteosarcoma Study (EURAMOS)) in patients diag...
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| Format: | Article |
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MDPI AG
2020-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/12/4070 |
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| author | Adriana Fonseca Anne L. Ryan Paul Gibson Eleanor Hendershot Sevan Hopyan Marilyn Ranson Jennifer Stimec Abha A. Gupta |
| author_facet | Adriana Fonseca Anne L. Ryan Paul Gibson Eleanor Hendershot Sevan Hopyan Marilyn Ranson Jennifer Stimec Abha A. Gupta |
| author_sort | Adriana Fonseca |
| collection | DOAJ |
| description | Objective: We examined the interobserver reliability of local progressive disease (L-PD) determination using two major radiological response evaluation criteria systems (Response evaluation Criteria in Solid Tumors (RECIST) and the European and American Osteosarcoma Study (EURAMOS)) in patients diagnosed with localized osteosarcoma (OS). Additionally, we describe the outcomes of patients determined to experience L-PD. Materials and Methods: Forty-seven patients diagnosed with localized OS between 2000 and 2012 at our institution were identified. Paired magnetic resonance imaging of the primary tumor from diagnosis and post-neoadjuvant chemotherapy were blindly assessed by two experienced radiologists and determined L-PD as per RECIST and EURAMOS radiological criteria. Interobserver reliability was measured using the kappa statistic (κ). The Kaplan Meier method and log-rank test was used to assess differences between groups. Results: Of 47 patients (median age at diagnosis 12.9 years), 16 (34%) had L-PD (by RECIST or EURAMOS radiological definition). There was less agreement between the radiologists using EURAMOS radiological criteria for L-PD (80.9%, κ = 0.48) than with RECIST criteria (97.9%, κ = 0.87). Patients with radiologically defined L-PD had a 5-year progression-free survival (PFS) of 55.6%, compared to a 5 year-PFS of 82.7% in the group of patients without L-PD (<i>n</i> = 31) (Log rank <i>p</i> = 0.0185). Conclusions: The interobserver reliability of L-PD determination is higher using RECIST than EURAMOS. RECIST can be considered for response assessment in OS clinical trials. The presence of L-PD was associated with worse outcomes. |
| first_indexed | 2024-03-10T14:00:28Z |
| format | Article |
| id | doaj.art-d1a5697ab4e544bc847cdee7a22021e5 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T14:00:28Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d1a5697ab4e544bc847cdee7a22021e52023-11-21T01:13:47ZengMDPI AGJournal of Clinical Medicine2077-03832020-12-01912407010.3390/jcm9124070Radiological Assessment and Outcome of Local Disease Progression after Neoadjuvant Chemotherapy in Children and Adolescents with Localized OsteosarcomaAdriana Fonseca0Anne L. Ryan1Paul Gibson2Eleanor Hendershot3Sevan Hopyan4Marilyn Ranson5Jennifer Stimec6Abha A. Gupta7Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON M5G 1X8, CanadaDepartment of Heamatology and Oncology, Perth Children’s Hospital, Perth 6009, AustraliaDivision of Hematology/Oncology, McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, CanadaDivision of Hematology/Oncology, McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, CanadaDepartment of Orthopedic Surgery, Hospital for Sick Children, Toronto, ON M5G 1X8, CanadaDepartment of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON M5G 1X8, CanadaDepartment of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON M5G 1X8, CanadaDivision of Hematology/Oncology, Hospital for Sick Children, Toronto, ON M5G 1X8, CanadaObjective: We examined the interobserver reliability of local progressive disease (L-PD) determination using two major radiological response evaluation criteria systems (Response evaluation Criteria in Solid Tumors (RECIST) and the European and American Osteosarcoma Study (EURAMOS)) in patients diagnosed with localized osteosarcoma (OS). Additionally, we describe the outcomes of patients determined to experience L-PD. Materials and Methods: Forty-seven patients diagnosed with localized OS between 2000 and 2012 at our institution were identified. Paired magnetic resonance imaging of the primary tumor from diagnosis and post-neoadjuvant chemotherapy were blindly assessed by two experienced radiologists and determined L-PD as per RECIST and EURAMOS radiological criteria. Interobserver reliability was measured using the kappa statistic (κ). The Kaplan Meier method and log-rank test was used to assess differences between groups. Results: Of 47 patients (median age at diagnosis 12.9 years), 16 (34%) had L-PD (by RECIST or EURAMOS radiological definition). There was less agreement between the radiologists using EURAMOS radiological criteria for L-PD (80.9%, κ = 0.48) than with RECIST criteria (97.9%, κ = 0.87). Patients with radiologically defined L-PD had a 5-year progression-free survival (PFS) of 55.6%, compared to a 5 year-PFS of 82.7% in the group of patients without L-PD (<i>n</i> = 31) (Log rank <i>p</i> = 0.0185). Conclusions: The interobserver reliability of L-PD determination is higher using RECIST than EURAMOS. RECIST can be considered for response assessment in OS clinical trials. The presence of L-PD was associated with worse outcomes.https://www.mdpi.com/2077-0383/9/12/4070osteosarcomaMRIradiological progression |
| spellingShingle | Adriana Fonseca Anne L. Ryan Paul Gibson Eleanor Hendershot Sevan Hopyan Marilyn Ranson Jennifer Stimec Abha A. Gupta Radiological Assessment and Outcome of Local Disease Progression after Neoadjuvant Chemotherapy in Children and Adolescents with Localized Osteosarcoma Journal of Clinical Medicine osteosarcoma MRI radiological progression |
| title | Radiological Assessment and Outcome of Local Disease Progression after Neoadjuvant Chemotherapy in Children and Adolescents with Localized Osteosarcoma |
| title_full | Radiological Assessment and Outcome of Local Disease Progression after Neoadjuvant Chemotherapy in Children and Adolescents with Localized Osteosarcoma |
| title_fullStr | Radiological Assessment and Outcome of Local Disease Progression after Neoadjuvant Chemotherapy in Children and Adolescents with Localized Osteosarcoma |
| title_full_unstemmed | Radiological Assessment and Outcome of Local Disease Progression after Neoadjuvant Chemotherapy in Children and Adolescents with Localized Osteosarcoma |
| title_short | Radiological Assessment and Outcome of Local Disease Progression after Neoadjuvant Chemotherapy in Children and Adolescents with Localized Osteosarcoma |
| title_sort | radiological assessment and outcome of local disease progression after neoadjuvant chemotherapy in children and adolescents with localized osteosarcoma |
| topic | osteosarcoma MRI radiological progression |
| url | https://www.mdpi.com/2077-0383/9/12/4070 |
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