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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Research article

Pathological fractures in predicting clinical outcomes for patients with osteosarcoma

Authors: Lien-Hsiang Chung, Po-Kuei Wu, Cheng-Fong Chen, Hung-Kai Weng, Tain-Hsiung Chen, Wei-Ming Chen

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

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Abstract

Background

Studies reported contradictory results for the prognostic significance of a pathological fracture in osteosarcoma patients. The aim of this study is to report the outcomes for a cohort of patients with osteosarcoma who presented with and without pathological fractures and to identify the prognostic importance of pathological fracture in predicting outcomes and influences on survival.

Methods

Data of patients with osteosarcoma were retrospectively reviewed. Between March 1992 and June 2014, a total of 268 patients with osteosarcoma were included in this analysis, of whom 34 (12.7%) with fractures at diagnosis or sustained after chemotherapy and 234 (87.3%) without fracture. All patients were treated with approaches that integrated chemotherapy and surgical resections to maximal extent of all sites whenever feasible. The association between potential prognostic factors and survival for these patients were analyzed and compared.

Results

No significant difference was observed in overall survival, progression free survival, and disease free survival between osteosarcoma patients with pathological fractures and without fracture. The patients without fracture had a 5-year survival of 50% and 10-year survival of 21%, in contrast to 37% (5-year) and 22% (10-year) in patients with fractures. Lung metastasis was the significant predictor for the presence of fractures. Advanced stage (III) of tumor, lung metastasis, poor response to chemotherapy, and local recurrence were associated increased risk for death in all osteosarcoma patients.

Conclusion

Pathological fracture is not a predictor of worse survival in this study. Further studies with matched cases are needed to confirm our observations.
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Metadata
Title
Pathological fractures in predicting clinical outcomes for patients with osteosarcoma
Authors
Lien-Hsiang Chung
Po-Kuei Wu
Cheng-Fong Chen
Hung-Kai Weng
Tain-Hsiung Chen
Wei-Ming Chen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1351-x

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