Cancer Medicine

Open Access

ORIGINAL RESEARCH

Reassessment of alkaline phosphatase as serum tumor marker with high specificity in osteosarcoma Seung Hyun Kim1 , Kyoo-Ho Shin1, Seong-Hwan Moon1, Jinyoung Jang1, Hyo Song Kim2, Jin-Suck Suh3 & Woo-Ick Yang4 1Department

of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea 3Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea 4Department of Pathology, Yonsei University College of Medicine, Seoul, Korea 2Division

Keywords Alkaline Phosphatase, High specificity, Osteosarcoma, Serum Tumor Marker Correspondence Kyoo-Ho Shin, Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea. Tel: +82-2-2228-2189, Fax: +82-2-363-1139; E-mail: [email protected] Funding Information This study was not funded by any external source. Received: 16 August 2016; Revised: 2 January 2017; Accepted: 4 January 2017 Cancer Medicine 2017; 6(6):1311–1322 doi: 10.1002/cam4.1022

Abstract The goal of this study was to reassess serum alkaline phosphatase (ALP) as tumor marker in osteosarcoma. We retrospectively examined serum ALP levels at diagnosis, every therapeutic step (neoadjuvant chemotherapy, surgery, and adjuvant chemotherapy), metastasis, and follow-­ up and analyzed the role of ALP as tumor marker in 210 osteosarcomas. The diagnostic performances of ALP were validated with pathology-­ proven 899 other primary bone lesions. Elevated ALP at diagnosis was associated with inferior overall survival (OS) (Log Rank P