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Cyclooxygenase-2 overexpression predicts poor survival in patients with high-grade extremity osteosarcoma: a pilot study
Clinical Orthopedics and Related Research, 04/01/09
Urakawa H et al. - In a trial to determine whether cyclooxygenase-2 (COX-2) overexpression predicts poor survival in pts with high-grade extremity osteosarcoma, preliminary data suggest COX-2 overexpression in the primary tumor correlates with occurrence of distant metastasis in pts with osteosarcoma and also may affect postmetastatic survival.
Methods- Expression levels of COX-2 were examined immunohistochemically in 51 pts 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.
- No correlation was found 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 >20 yrs and strong COX-2 expression independently predicted increased risk of metastasis.
- Among 7 pts with resectable lung metastasis, all 3 with greater COX-2 expression in the metastatic lesion than that in a primary site died of the disease.
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