Relative Wash-In Rate in Dynamic Contrast-Enhanced Magnetic Resonance Imaging as a New Prognostic Biomarker for Event-Free Survival in 82 Patients with Osteosarcoma: A Multicenter Study.
Cancers (Basel)
; 16(11)2024 May 21.
Article
en En
| MEDLINE
| ID: mdl-38893075
ABSTRACT
BACKGROUND:
The decreased perfusion of osteosarcoma in dynamic contrast-enhanced (DCE) MRI, reflecting a good histological response to neoadjuvant chemotherapy, has been described.PURPOSE:
In this study, we aim to explore the potential of the relative wash-in rate as a prognostic factor for event-free survival (EFS).METHODS:
Skeletal high-grade osteosarcoma patients, treated in two tertiary referral centers between 2005 and 2022, were retrospectively included. The relative wash-in rate (rWIR) was determined with DCE-MRI before, after, or during the second cycle of chemotherapy (pre-resection). A previously determined cut-off was used to categorize patients, where rWIR < 2.3 was considered poor and rWIR ≥ 2.3 a good radiological response. EFS was defined as the time from resection to the first event local recurrence, new metastases, or tumor-related death. EFS was estimated using Kaplan-Meier's methodology. Multivariate Cox proportional hazard model was used to estimate the effect of histological response and rWIR on EFS, adjusted for traditional prognostic factors.RESULTS:
Eighty-two patients (median age 17 years; IQR 14-28) were included. The median follow-up duration was 11.8 years (95% CI 11.0-12.7). During follow-up, 33 events occurred. Poor histological response was not significantly associated with EFS (HR 1.8; 95% CI 0.9-3.8), whereas a poor radiological response was associated with a worse EFS (HR 2.4; 95% CI 1.1-5.0). In a subpopulation without initial metastases, the binary assessment of rWIR approached statistical significance (HR 2.3; 95% CI 1.0-5.2), whereas its continuous evaluation demonstrated a significant association between higher rWIR and improved EFS (HR 0.7; 95% CI 0.5-0.9), underlining the effect of response to chemotherapy. The 2- and 5-year EFS for patients with a rWIR ≥ 2.3 were 85% and 75% versus 55% and 50% for patients with a rWIR < 2.3.CONCLUSION:
The predicted poor chemo response with MRI (rWIR < 2.3) is associated with shorter EFS even when adjusted for known clinical covariates and shows similar results to histological response evaluation. rWIR is a potential tool for future response-based individualized healthcare in osteosarcoma patients before surgical resection.
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Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Cancers (Basel)
Año:
2024
Tipo del documento:
Article
País de afiliación:
Países Bajos
Pais de publicación:
Suiza