The effect of pathological fractures on the prognosis of patients with osteosarcoma: a meta-analysis of 14 studies

Oncotarget
Yifei ZhouFengfeng Wu

Abstract

Osteosarcoma is a leading cause of malignant tumor related death. We conducted a meta-analysis to evaluate the association between pathological fractures and prognosis in patients with osteosarcoma. We searched PubMed, Web of Science, and Embase for studies published until May 15, 2017. Crude and adjusted relative risk (RR) with 95% confidence intervals were used to compare data between the case and control groups. Fourteen studies and 3910 patients were included in the final meta-analysis. No statistically significant difference was detected between the pathological fracture and non-pathological fracture groups in local recurrences analysis (RR = 1.102, 95% CI: 0.813-1.495, P = 0.531); however, a statistically significant difference was found between group in distant metastasis (RR = 1.424, 95% CI: 1.089-1.862, P = 0.01). For survival rates, the following RRs were calculated: 3-year overall survival (OS) (RR = 0.736, 95% CI: 0.593-0.912, P = 0.005); 5-year OS (RR = 0.889, 95% CI: 0.791-0.999, P = 0.049); 3-year event-free survival (EFS) (RR = 0.812, 95% CI: 0.682-0.966, P = 0.018); and 5-year EFS (RR = 0.876, 95% CI: 0.785-0.978, P = 0.019). The pooled estimate of RR was 0.673 (95% CI: 0.364-1.244, P = 0.206) for local recurre...Continue Reading

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