A study of suicide risk and prognostic characteristics in patients with osteosarcoma.

OBJECTIVE This study aimed to investigate the risk factors for suicide and the prognosis of osteosarcoma patients with tumours located in the extremities, trunk, head, and facial bones.

METHODS We retrospectively analyzed data from 3,873 patients to assess risk factors for suicide. Of these patients, 2,062 were selected for survival analysis, with overall survival (OS) as the primary endpoint. Logistic and Cox regression analyses were used to investigate associations between variables, adjusting for confounders such as age, sex, tumour stage, and histological type. Results: Six patients (0.15%) died by suicide (6/3,873). After adjusting for other confounders, age 40-59 years (adjusted odds ratio [aOR] 14.42, P = 0.002) and chondroblastic osteosarcoma (aOR = 5.821, P = 0.012) were identified as independent risk factors. Five-year OS rates were comparable across age groups (e.g., <20 years: 58%, >59 years: 37%, all P < 0.05). Among histological types, patients with parosteal osteosarcoma had the highest 5-year OS rate (e.g., parosteal osteosarcoma: 84% versus osteosarcoma not otherwise specified: 49%, P < 0.001). Multivariable Cox regression revealed that age and histology exhibited significant associations with the survival outcomes.

CONCLUSIONS In osteosarcoma patients with tumours in the extremities, trunk, head, and facial bones, age and histological type were independent risk factors for both suicide and survival outcomes. These findings highlight the need for clinicians to consider both clinical and psychological risk factors in patient management and underscore the importance of providing mental health counselling, particularly for those at high risk for suicide.