Evidence map›Paper›PMID 39966776›Full record

ArticleBMC cancer2025

Comparison of overall survival of adult and pediatric osteosarcoma patients using the national cancer database.

Ryan Boyland, Saber Amin, Valerie Shostrom, Cheng Zheng, Jenna Allison, Chi Lin

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ryan BoylandDepartment of Emergency Medicine, Denver Health Medical Center, Denver, CO, USA.
Saber AminDepartment of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA.
Valerie ShostromDepartment of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA.
Cheng ZhengDepartment of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA.
Jenna AllisonDepartment of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA.
Chi LinDepartment of Emergency Medicine, Denver Health Medical Center, Denver, CO, USA. Clin@unmc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDifferences in overall survival (OS) between pediatric and adult patients diagnosed with osteosarcoma are poorly understood. The objective of this study is to compare the OS of pediatric and adult patients with osteosarcoma, identify prognostic factors associated with OS, and explore factors specifically associated with pediatric osteosarcoma using data gathered from the National Cancer Database (NCDB).

methodsPatients > = 1 years old and diagnosed with osteosarcoma between 2004 and 2017 were included in the study. Multivariable Cox regression analysis adjusted for gender, race, income, education, place of living, health insurance status, year of diagnosis, stage of cancer, surgery, chemotherapy, and radiation therapy (RT) was used to assess the association of age with the OS of the patients.

resultsThe analysis included 8,458 patients among whom 3,027 (35.8%) were between 1 and 17 years old. In the multivariable Cox regression analysis, adult patients had worse OS compared with pediatric patients (HR: 1.84; p < .01). When stratified by treatment type, pediatric patients had better OS in several groups. This includes those who received chemotherapy alone (HR: 0.58, p < .01), surgery alone (HR: 0.48, p < .01), surgery plus chemotherapy (HR: 0.56, p < .01), and those who received no treatment (HR: 0.31, p < .01). There was no significant difference in OS between pediatric and adult patients receiving a combination of chemotherapy, surgery, and RT (HR: 0.81, p = .42). In analysis stratified by cancer stage, pediatric patients had better OS compared to adult patients at each stage. Multivariable logistic regression analysis revealed that pediatric patients are more likely to be non-white, have insurance, present with unknown/occult stage disease, have poorly differentiated tumors, and receive chemotherapy, or surgery. Additionally, multivariable Cox regression analysis identified factors associated with improved OS: age, diagnosis between 2011 and 2015, private insurance, non-metastatic disease, well-differentiated tumors, and receiving chemotherapy or surgery, but not RT.

conclusionPediatric patients diagnosed with osteosarcoma had better OS compared to their adult counterparts. Pediatric patients had better OS compared to adults when the analysis was stratified by treatment modality and stage of cancer. Further research is necessary to elucidate the underlying reason for this difference.

Indexed as

Bone NeoplasmsOsteosarcomaAdolescentAdultAgedAge FactorsChildChild, PreschoolDatabases, FactualFemaleHumansInfantMaleMiddle AgedPrognosisProportional Hazards ModelsHazard ratioOdds ratioOsteosarcomaOverall survivalPediatric

Identifiers

PMID39966776
PMCPMC11837598

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.