Evaluation of Nuclear Factor of Activated T-cells (NFATc1) Expression in Non-metastatic Osteosarcoma Tissue

Osteosarcoma, a primary malignant bone tumour, poses significant challenges in treatment and prognosis despite advancements in therapy. The expression of nuclear factor of activated T cells c1 (NFATc1) in osteosarcoma tissue remains underexplored as a potential therapeutic target. This study aimed to evaluate NFATc1 protein expression in human non-metastatic osteosarcoma tissue samples and its correlation with patient survival and its subtypes. Secondarily, we examined the association between clinico-demographic details and survival of osteosarcoma patients. A cross-sectional study was conducted on 31 patients with primary non-metastatic osteosarcoma. Immunohistochemical analysis was used to assess NFATc1 protein expression in surgically resected tissue specimens. Demographic data, treatment details and follow-up records were collected for analysis. The study population had a mean age of 20.0 years, with Malay ethnicity being predominant. NFATc1 protein expression was positive in 25.8% of cases predominantly in conventional osteosarcoma (30.4%). No significant correlation was found between NFATc1 protein expression and patient survival (p = 0.685) or osteosarcoma subtypes (p = 0.642). NFATc1-positive patients had lower odds of long-term survival compared to NFATc1-negative patients (OR = 0.550; 95% CI: 0.106 - 2.860), although this association was not statistically significant (p = 0.477). Among the clinico-demographic characteristics, only the type of surgery (limb salvage vs. amputation) showed a statistically significant association with survival (p = 0.002), while age, race, gender, site, pathological fracture, chemotherapy and surgery for recurrence did not. Therefore, NFATc1 alone does not appear to be a useful prognostic biomarker in non-metastatic osteosarcoma. Further study is recommended to explore NFATc1 in larger cohort of both non-metastatic and metastatic osteosarcoma.