Volume 27, Issue 12 (Monthly-Mar 2017)                   Studies in Medical Sciences 2017, 27(12): 1068-1073 | Back to browse issues page

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hajialilo sami S, jamshidi K, abolghasemzade ahangar F. prognostic importance of the pathologic fracture and surgical options in osteosarcoma: a retrospective clinical study. Studies in Medical Sciences 2017; 27 (12) :1068-1073
URL: http://umj.umsu.ac.ir/article-1-3468-en.html
Fellowship in orthopaedics tumor surgery, Shafa Yahyaeian bone and joint research center, Iran university of medical sciences(Corresponding Author) , farshada1358@gmail.com
Abstract:   (5210 Views)

Background & Aims: Osteosarcoma is one of the most prevalent malignant bone tumors . This study is designed to assess the prognostic effect of pathologic fracture and treatment options on survival of patients with osteosarcoma.

Materials & Methods: In this study, prognosis of 106 patients with limb osteosarcoma, which were treated at three  hospitals in Tehran from April to August 2012 was evaluated. Patients were divided in two groups according to the presence of pathologic fracture at the time of diagnosis.  Survival, local recurrence and distant metastasis were compared between groups. For patients with pathologic fracture, survival rate was compared according to surgical options (amputation or limb salvage). Chi-square and Independent sample T-test were used to compare means of the groups. Recurrence free and metastasis free survivals and final survival of the patients were calculated using the Kaplan-Meier method. To determine the predictive factors of survival, Cox-Regression analysis and estimating hazard ratio (HR) with 95% confidence interval were used.

Results: Among 106 patients, 57 cases had not and 49 others had a pathologic fracture at the time of diagnosis. There were no statistically difference between two groups in Survival (P-value=0.36), local recurrence (P-value=0.91) and distant metastasis (P-value=0.73).  There was no statistically difference in survival according to surgical options in patients with pathologic fracture (P-value=0.85).

Conclusion: pathologic fracture in limb osteosarcoma is not a poor prognostic factor. In patients with pathologic fracture limb salvage procedures can be performed without adverse effect on survival rate.

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Type of Study: Research | Subject: Orthopedic

1. Canale ST, Beaty JH. Campbell’s Operative Orthopaedics. Elsevier Health Sciences; 2012. volume 1, chapter 22, P.901-7. [Article]
2. Abudu A, Sferopoulos NK, Tillman RM, Carter SR, Grimer RJ. The surgical treatment and outcome of pathological fractures in localised osteosarcoma. J Bone Joint Surg Br 1996;78(5): 694–8. [Google Scholar]
3. Coley BL, Pool JL. Factors influencing the prognosis in osteogenic sarcoma. Ann Surg 1940;112(6): 1114–28. [Google Scholar]
4. Jaffe N, Spears R, Eftekhari F, Robertson R, Cangir A, Takaue Y, et al. Pathologic fracture in osteosarcoma. Impact of chemotherapy on primary tumor and survival. Cancer 1987;59(4): 701–9. [Google Scholar]
5. Mulder Jo, Schutte HE, Kroon HM, Taconis WK. Radiologic atlas of bone tumors- Amsterdam: Elsevier science; 1993. Intraosseous osteosarcoma: conventional type; P51-5. [Google Scholar]
6. Scully SP, Temple HT, O’Keefe RJ, Mankin HJ, Gebhardt M. The surgical treatment of patients with osteosarcoma who sustain a pathologic fracture. Clin Orthop Relat Res 1996;(324): 227–32. [Google Scholar]
7. Scully SP, Ghert MA, Zurakowski D, Thompson RC, Gebhardt MC. Pathologic fracture in osteosarcoma : prognostic importance and treatment implications. J Bone Joint Surg Am 2002;84–A(1): 49–57. [PubMed]
8. Canale ST, Beaty JH. Campbell’s Operative Orthopaedics. 12th ed. Elsevier Health Sciences; 2012. volume 1, chapter 19, 785-7. [Google Scholar]
9. 9. Simon MA. Limb salvage for osteosarcoma. J Bone Joint Surg Am 1988;70(2): 307–10. [Google Scholar]
10. Simon MA, Aschliman MA, Thomas N, Mankin HJ. Limb-salvage treatment versus amputation for osteosarcoma of the distal end of the femur. J Bone Joint Surg Am 1986;68(9): 1331–7. [Google Scholar]
11. Griffin Am, Mclaughlin C, Ferguson PC, Bell RS, Wunder JS. Outcome following presentation with a pathologic fracture in osteosarcoma.J Bone Joint Surg Br 2008; 90: 87-8. [Google Scholar]
12. Bacci G, Ferrari S, Longhi A, Donati D, Manfrini M. Nonmetastatic osteosarcoma of the extremity wiyh pathologic fracture at presentation: local and systemic control by amputation or limb salvage after preoperative chemotherapy. Aceta orthop Scand 2003; 74: 449-54. [Google Scholar]

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