Clinical and functional outcomes of patients with a pathologic fracture in high-grade osteosarcoma

Journal of Surgical Oncology
Peter C FergusonJ S Wunder

Abstract

There have been variable reports of outcomes of patients with osteosarcoma and pathologic fractures. The purpose of this study was to document outcomes after management of this clinical entity at a single large oncology center. A retrospective review was undertaken of our database between 1989 and 2006. We compared oncologic and functional outcomes of 201 patients with high-grade osteosarcoma without pathologic fractures to 31 patients with pathologic fractures. The rate of amputation in the group with pathologic fracture was significantly higher than the group without fracture (39% vs. 14%, P = 0.001). There was no difference in the rate of local recurrence between groups. The 5-year survival was superior in the group without pathologic fracture (60% vs. 41%, P = 0.0015). For patients with localized disease, 5-year survival was higher in patients without fracture (68% vs. 52%, P = 0.006). Disability as measured by the Toronto Extremity Salvage Score was no different between the groups. Impairment as measured by the Musculoskeletal Tumor Society scores was lower in the group without fracture. Presentation with a pathologic fracture in osteosarcoma did not preclude limb salvage surgery in a majority of patients, did not increase...Continue Reading

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Citations

Sep 4, 2012·Pediatric Emergency Care·Karl Muchantef, Avrum N Pollock
Oct 6, 2012·Clinical Sarcoma Research·Alvin Jm NgCarl R Walkley
Jun 27, 2013·World Journal of Surgical Oncology·Dongqing ZuoZhengdong Cai
Feb 21, 2016·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·J M M Cates
Mar 22, 2016·Journal of Bone Oncology·Xiaojuan LiZuozhang Yang
Mar 26, 2016·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·A A SalunkeJ Pandit
Sep 19, 2014·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Lingling SunZhaoming Ye
Jul 20, 2014·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·S IwataR J Grimer
Dec 30, 2016·BMC Musculoskeletal Disorders·Lien-Hsiang ChungWei-Ming Chen
Jan 15, 2017·Journal of Orthopaedic Surgery and Research·Xiaojun HePeng Fu
Dec 27, 2017·JBJS Reviews·Russell N StitzleinKristy L Weber
Aug 8, 2019·Clinical Orthopaedics and Related Research·Santiago A Lozano CalderónDimitrios Spentzos
Jan 14, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lisa Marie KelleyIrene von Lüttichau
Apr 24, 2013·Bone & Joint Research·C B R De MattosJ P Dormans
Nov 30, 2016·Pediatric Blood & Cancer·Lindsay HaynesIsrael Fernandez-Pineda
Oct 9, 2021·The Journal of the American Academy of Orthopaedic Surgeons·John H AlexanderDavid M Joyce

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