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Prognostic Modeling for Bone Sarcomas based on a Large Prospective Cohort from a Tertiary Care Cancer Centre in India
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  • Laboni Sarkar,
  • Jyoti Bajpai,
  • Sushmita Rath,
  • Akash Pawar,
  • Arun Chandrasekharan,
  • Goutam Panda,
  • Dharmpal Jakar,
  • Jaya Ghosh,
  • Siddhartha Laskar,
  • Bharat Rekhi,
  • Nehal Khanna,
  • Jifmi Manjali,
  • Mukta Ramdawar,
  • Nilendu Purandare,
  • Prabhat Bhargava,
  • Nivedita Chakrabarty,
  • Kunal Gala,
  • Yogesh Kembhavi,
  • Venkatesh Rangarajan,
  • Sripad Banavali,
  • Sudeep Gupta
Laboni Sarkar
Homi Bhabha National Institute
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Jyoti Bajpai
Homi Bhabha National Institute

Corresponding Author:drjyotibajpai25@gmail.com

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Sushmita Rath
Homi Bhabha National Institute
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Akash Pawar
Homi Bhabha National Institute
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Arun Chandrasekharan
Homi Bhabha National Institute
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Goutam Panda
Homi Bhabha National Institute
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Dharmpal Jakar
Homi Bhabha National Institute
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Jaya Ghosh
Homi Bhabha National Institute
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Siddhartha Laskar
Tata Memorial Centre Department of Radiation Oncology
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Bharat Rekhi
Homi Bhabha National Institute
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Nehal Khanna
Tata Memorial Centre Department of Radiation Oncology
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Jifmi Manjali
Tata Memorial Centre Department of Radiation Oncology
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Mukta Ramdawar
Homi Bhabha National Institute
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Nilendu Purandare
Homi Bhabha National Institute
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Prabhat Bhargava
Homi Bhabha National Institute
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Nivedita Chakrabarty
Tata Memorial Centre Department of Radiodiagnosis
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Kunal Gala
Tata Memorial Centre Department of Radiodiagnosis
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Yogesh Kembhavi
Homi Bhabha National Institute
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Venkatesh Rangarajan
Homi Bhabha National Institute
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Sripad Banavali
Homi Bhabha National Institute
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Sudeep Gupta
Homi Bhabha National Institute
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Abstract

Background: Outcomes of adolescents and young adults (AYA) with bone sarcomas inclusive of osteosarcoma (OGS) and Ewing’s sarcoma (ES) are impacted by various factors including inadvertent prior treatment and poor compliance. We aimed to identify prognostic factors and derive prognostic models for these patients. Methods: All AYA OGS and ES cases treated at our institute with the “OGS-12” and Ewing’s family of tumors-2001 (“EFT-2001”) protocols from 2011 to 2021, and 2013 to 2018 respectively, were prospectively analyzed. Results:. Among 606/748 (81.0%) AYA with non-metastatic osteosarcoma, significant factors included in the prognostic model were failure to complete protocol (hazard ratio (HR) 2.65, 95% confidence interval (CI) 1.65-4.26), prior treatment (HR 2.93, CI 1.4-6.1), necrosis <90% (HR 1.63, CI 1.24-2.1), joint involvement (HR 2.0, CI 1.49-2.69) and SAP> median (204 U/l) (HR 1.63, CI 1.24-2.14). Of 104/263 (39.5%) AYA ES, significant factors were failure to complete protocol (HR 2.84, CI 1.03-7.8), prior treatment (HR 6.37, CI 1.8-22.0), necrosis <100% (HR 8.73, CI 2.16-35.3), and tumor size >8cm (HR 2.64, CI 1.04-6.7). For 142/366 (38.8%) AYA with metastatic OGS, significant factors were failure to complete protocol (HR 5.29), metastases not amenable to local treatment (HR 1.96), necrosis <90% (HR 1.96), and >10 metastases (HR 2.44). For 38/82 (43.6%) AYA with metastatic extremity ES, significant factors were failure to complete protocol (HR 3.88) and metastases not amenable to local treatment (HR 10.6). Conclusion: We developed simple, effective prognostic models for AYA with bone sarcomas with wide applicability in LMIC.