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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2010

01-03-2010 | Bone and Soft Tissue Sarcomas

Differential Presentations, Clinical Courses, and Survivals of Osteosarcomas of the Proximal Humerus over Other Extremity Locations

Authors: Wan Hyeong Cho, MD, Won Seok Song, MD, Dae-Geun Jeon, MD, Chang-Bae Kong, MD, Min Suk Kim, MD, Jun Ah Lee, MD, Ji Young Yoo, MD, Jae Do Kim, MD, Soo-Yong Lee, MD

Published in: Annals of Surgical Oncology | Issue 3/2010

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Abstract

Background

Although there are controversies about the prognosis of proximal humeral osteosarcoma, our previous study showed poor survival in those patients. In the present study, we undertook to determine why this site is associated with a poor outcome and to identify the clinicopathologic variables involved.

Methods

The study cohort consisted of 36 proximal humeral and 341 other extremity American Joint Committee on Cancer (AJCC) stage II osteosarcomas. We examined the clinicopathologic differences between these osteosarcomas. The prognostic significances of factors identified for a proximal humoral location were evaluated by survival analysis of all 377 patients.

Results

Patients with a proximal humeral osteosarcoma had the following characteristics: a higher incidence of pathologic fracture (P < 0.01), an osteolytic pattern on plain radiographs (P < 0.01), an unusual pathological subtype (P = 0.01), poor histologic response (P < 0.01), and an increased tumor-volume ratio (TVR) (P < 0.01). Multivariate analysis revealed that a large tumor volume (P < 0.01), an increase in tumor volume (P < 0.01), and a poor histologic response to preoperative chemotherapy (P < 0.01) independently predicted shorter metastasis-free survival.

Conclusions

The association between proximal humeral osteosarcoma and poor survival could be the result of unresponsiveness to chemotherapy, which was expressed by a tumor volume increase in our patients.
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Metadata
Title
Differential Presentations, Clinical Courses, and Survivals of Osteosarcomas of the Proximal Humerus over Other Extremity Locations
Authors
Wan Hyeong Cho, MD
Won Seok Song, MD
Dae-Geun Jeon, MD
Chang-Bae Kong, MD
Min Suk Kim, MD
Jun Ah Lee, MD
Ji Young Yoo, MD
Jae Do Kim, MD
Soo-Yong Lee, MD
Publication date
01-03-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 3/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0825-6

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