Impact of Pathological Fractures on the Prognosis of Primary Malignant Bone Sarcoma in Children and Adults: A Single-Center Retrospective Study of 205 Patients.

Schlegel, Miriam; Zeumer, Martina; Prodinger, Peter Michael; Woertler, Klaus; Steinborn, Marc; von Eisenhart-Rothe, Rüdiger; Burdach, Stefan; Rechl, Hans; von Luettichau, Irene

doi:10.1159/000487142

journal article

Title:: Impact of Pathological Fractures on the Prognosis of Primary Malignant Bone Sarcoma in Children and Adults: A Single-Center Retrospective Study of 205 Patients.
Document type:: Journal Article
Author(s):: Schlegel, Miriam; Zeumer, Martina; Prodinger, Peter Michael; Woertler, Klaus; Steinborn, Marc; von Eisenhart-Rothe, Rüdiger; Burdach, Stefan; Rechl, Hans; von Luettichau, Irene
Abstract:: The purpose of this study was to investigate whether pathological fractures (PF) influence the prognosis of patients with osteosarcoma (OS) or Ewing tumor (ET) regarding 5-year survival, occurrence of metastases, and local recurrence.We retrospectively analyzed 205 patients with metastatic and nonmetastatic OS or ET. Survival analysis was performed for all patients and differentiated for patients with OS (n = 127) and ET (n = 78) as well as for adults (n = 101) and children (n = 104).Patients with PF showed survival rates of 64% compared to 83% for those without PF (p = 0.023). Local recurrence occurred in 7% of the patients without and in 24% of those with PF (p = 0.023). In patients with ET and in children, survival analysis showed no significant difference between patients with and without PF in survival and local recurrence rates. In patients with OS, survival rate decreased from 83 to 59% (p = 0.024) and local recurrence rate increased from 13 to 30% (p = 0.042). In adults, survival rate decreased from 78 to 51% (p = 0.004) and local recurrence rate increased from 13 to 42% (p < 0.001). In multivariate analysis, age and PF were associated with inferior survival.This study suggests that the occurrence of PF has a negative impact on survival and implicates an increased risk of local recurrence. In children and in patients with ET, PF did not have a prognostic impact.
Journal title abbreviation:: Oncology
Year:: 2018
Journal volume:: 94
Journal issue:: 6
Pages contribution:: 354-362
Fulltext / DOI:: doi:10.1159/000487142
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/29656296
Print-ISSN:: 0030-2414
TUM Institution:: Klinik und Poliklinik für Kinderheilkunde und Jugendmedizin; Klinik und Poliklinik für Orthopädie und Sportorthopädie
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