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COX-2 Expression Correlates With Survival in Patients With Osteosarcoma Lung Metastases

Rodriguez, Nidra I. MD*; Hoots, William Keith MD*; Koshkina, Nadezhda V. PhD*; Morales-Arias, Jaime A. MD*; Arndt, Carola A. MD; Inwards, Carrie Y. MD; Hawkins, Douglas S. MD§; Munsell, Mark F. MS; Kleinerman, Eugenie S. MD*

Journal of Pediatric Hematology/Oncology: July 2008 - Volume 30 - Issue 7 - pp 507-512
doi: 10.1097/MPH.0b013e31816e238c
Commentaries

The purpose of this study was to determine whether a correlation exists between tumor cyclooxygenase (COX)-2 expression and disease-specific survival in patients with osteosarcoma lung metastases. Thirty-six patients diagnosed with osteosarcoma lung metastases between the years 1990 and 2001 were included in this retrospective study. The majority of the patients (72%) presented newly -diagnosed osteosarcoma lung metastases whereas the remaining patients (28%) presented recurrent disease. Clinicopathologic parameters were obtained from patients' clinical records. Tissue samples were obtained at the time of resection of the lung metastases and stained for COX-2 using immunohistochemistry. Samples were graded according to the intensity of COX-2 staining (grade 0: negative, grade 1: very weak, grade 2: weak, grade 3: moderate, and grade 4: strong). COX-2 staining was correlated with disease-specific survival and clinicopathologic parameters using the Jonckheere-Terpstra and the Kruskal-Wallis tests. All patients with grade 3 or 4 COX-2 expression died of osteosarcoma lung metastases. Ten percent of patients with grade 2 COX-2 expression and 29% of patients with grade 1 expression were alive and free of disease at the last follow-up. By contrast, 60% of the patients with grade 0 COX-2 expression were alive and free of disease at the last follow-up. No association between COX-2 expression and clinicopathologic parameters was found. However, COX-2 expression correlated inversely with disease-specific survival in patients with osteosarcoma lung metastases. Our data indicate that COX-2 expression in metastatic osteosarcoma may have prognostic significance.

*Department of Pediatrics, Children's Cancer Hospital

Department of Biostatistics and Applied Mathematics, The University of Texas MD Anderson Cancer Center, Houston, TX

Division of Pediatric Hematology Oncology

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN

§Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, WA

Reprints: Nidra I. Rodriguez, MD, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Box 87, Houston, TX 77030 (e-mail: nrodrigu@mdanderson.org).

Received for publication November 13, 2007; accepted February 6, 2008

© 2008 Lippincott Williams & Wilkins, Inc.