Three hematological indexes that may serve as prognostic indicators in patients with primary, high-grade, appendicular osteosarcoma

BACKGROUND: Although alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) are considered effective prognostic factors of osteosarcoma, useful prognostic biomarkers for patients with osteosarcoma are still lacking. METHODS: A retrospective study of 106 patients with primary, high-grade, appendicular osteosarcoma obtained between 2006 and 2011 was performed to assess the prognostic value of serum ALP, LDH and fibrinogen (FBG) levels, as well as their decrease rates in osteosarcoma. The Kaplan-Meier method was employed to analyze overall survival. The Cox proportional hazard model was used to determine the significance of these prognostic biomarkers on survival distribution. RESULTS: Patients with pre-ct (before neoadjuvant chemotherapy) LDH>210U/L, post-ct (after neoadjuvant chemotherapy, but before surgery) LDH>215U/L, post-ct FBG>2.8g/L, FBG DR (Decrease Rate)≤10% tended to have a poorer prognosis. CONCLUSIONS: High pre-ct and post-ct peripheral serum LDH level, high serum post-ct FBG level and low decrease rate of serum FBG were related to poor survival in patients with osteosarcoma. Fibrinogen was found to be a new valuable predictor of 5-year survival in patients with osteosarcoma for the first time.