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Table 1 Patient characteristics (N = 127)

From: Complete remission of metastatic osteosarcoma using combined modality therapy: a retrospective analysis of unselected patients in China

Items Number of patients Percentage (%) p for 2-y EFSa
Sex    0.759
 Male 83 65.4  
 Female 44 34.7  
Age (median: 15.0 years) Range: 5–56 (Q1, Q3, 15.1, 18.0) years 0.025
  < 40 years 124 97.6  
  ≥ 40 years 3 2.4  
Pathological Subtypes    0.526
 Conventional:chondroblastic 12 9.4  
 Conventional: osteoblastic 78 61.4  
 Conventional: not defined 24 18.9  
 Telangiectatic 5 3.9  
 Small cell 3 2.4  
 High-grade surface 1 0.8  
 Missing 4 3.1  
Primary site    0.328
 Distal femur 62 48.8  
 Proximal tibia and/or fibula 38 29.9  
 Proximal femur 4 3.2  
 Proximal humerus 9 7.1  
 Axial skeleton 7 5.5  
 Maxillofacial site 1 0.8  
 Others 6 4.7  
 Total number of pulmonary nodules for observation 605 100 0.963
Lung metastasis    0.464
  ≤ 5 nodules 88 69.3  
  > 5 nodules 39 30.7  
Lung metastasis    0.063
 Monolateral 48 37.8  
 Bilateral 79 62.2  
Local therapy for pulmonary nodules    0.476
 Resectionb 42 (85 nodules) 33.1  
 Radiotherapyc 79 (520 nodules) 62.2  
  Combined with resection and radiotherapy 6 4.7  
Missing nodules during follow-upd 52 7.9 (52/657) N/Ai
 For resection 15 15.0 (15/100)  
 For radiotherapy 37 6.6 (37/557)  
  Failed local resectione 8 9.4 (8/85)  
  Failed local radiotherapyf 14 2.7 (14/520)  
Dmaxg for pulmonary nodule/nodules    0.286
 3–5 mm 18 14.1  
 5–10 mm 29 22.8  
 10–20 mm 50 39.4  
  > 20 mm 30 23.6  
Systematic treatment during local therapy of pulmonary noduesh    0.426
 MAPI first-line chemotherapy 56 44.1  
 IE second-line chemotherapy 53 41.7  
 Targeted therapy 13 10.2  
 Combination of TKIS and IE chemo 4 3.2  
None 1 0.8  
 Median time for follow-up (months) 32.4 (95% CI: 30.8, 36.1) (Range: 10.4, 106.5)
  1. a2-y EFS: 2-year event-free survival, which was calculated from start of the local therapy (resection or radiotherapy) to any kind of progression as defined by RECIST 1.1
  2. bPulmonary metastasectomies were video-assisted thoracoscopic Surgery (VATS)
  3. cRadiotherapy usually involves GammaKnife or Cyber Knife with radio-dose > 60 Gy
  4. dBy comparing initial chest thin-layer computed tomography (CT) before local therapy and during follow-up, we observed that nodules had resolved or were undetectable with local treatment, most of which were observed as tiny or blurry nodules or even hardly been detected between infection and malignancy and would relapse after stopping systemic treatment
  5. eFailed local resection: local tumor relapse where previous tumor resection had been done
  6. fFailed local radiotherapy: local tumor relapse where previous radiation had been performed for curative tumor eradication
  7. gPatients were classified into four groups based on maximal nodule diameter: 1) 3 mm–5 mm; 2) 5 mm–10 mm; 3) 10 mm–20 mm; 4) > 20 mm
  8. hAt the Musculoskeletal Tumor Center of Peking University People’s Hospital and Peking University Shougang Hospital, a chemo-protocol that includes high-dose methotrexate, cisplatin, doxorubicin, and ifosfamide (MAPI) is used as first-line chemotherapy (seen in appendix Fig. 1); ifosfamide and etoposide (IE) as second-line systematic therapy; anti-angiogenesis tyrosine kinase inhibitors (TKIs) such as apatinib, anlotinib, cabozantinib, and regorafenib as third-line therapy; the combination of TKIs and IE chemotherapy as fourth-line therapy
  9. iData not available