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. 2009 Feb;467(2):510-8.
doi: 10.1007/s11999-008-0495-x. Epub 2008 Oct 15.

Osteosarcoma of the pelvis: outcome analysis of surgical treatment

Bruno Fuchs  1 , Nathan Hoekzema, Dirk R Larson, Carrie Y Inwards, Franklin H Sim
Affiliations

Osteosarcoma of the pelvis: outcome analysis of surgical treatment

Bruno Fuchs et al. Clin Orthop Relat Res. 2009 Feb.

Abstract

Risk factors to explain the poor survival of patients with osteosarcoma of the pelvis are poorly understood. Therefore, we attempted to identify factors affecting survival and development of local recurrence and metastasis. We retrospectively reviewed 43 patients who had high-grade pelvic tumors and were treated surgically. Twenty lesions were chondroblastic, 10 fibroblastic, 11 osteoblastic, and one each was giant cell-rich and small cell osteosarcomas. At a median of 3.5 years (range, 0.3-21 years) postoperatively, 13 patients were alive with no evidence of disease. The overall and disease-free 5-year survival rates were 38% and 29%, respectively, at 5 years. Anatomic location, tumor size, and margin predicted survival. Fifteen patients (35%) had local recurrence. The 5-year cumulative incidence of recurrence with death as a competing risk factor was 34%. Location in the ilium and size of the tumor predicted local recurrence. Twenty-one (49%) of 43 patients had metastases develop. The cumulative incidence of metastasis with death as a competing risk factor was 48% at 5 years. Six patients who presented with metastasis had a worse survival than patients who had no evidence of metastasis at presentation (2-year survival, 33% versus 76%). If distant metastasis is diagnosed subsequent to primary treatment, aggressive therapy may be justified.

Level of evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Figures

Fig. 1
Fig. 1
This Kaplan–Meier curve shows overall survival of the entire group of patients who had surgery for an osteosarcoma of the pelvis. Patients were censored at last known followup. The dotted curves represent the 95% confidence interval. The 5-year survival rate of the entire group was 38%. Location of the lesion, recurrence, and metastasis were the most important factors adversely affecting survival.
Fig. 2
Fig. 2
This Kaplan–Meier survival curve shows overall survival using an 18-month landmark. Patients were grouped into those who had local recurrence or metastasis within the first 18 months and those who were free of recurrence or metastasis at 18 months. This is a graphic representation of the time-dependent effect of recurrence and metastasis on survival. The dotted curves represent the 95% confidence intervals. Patients who had metastasis develop within the first 18 months had worse survival than those who did not.
Fig. 3
Fig. 3
This Kaplan–Meier curve shows the disease-free survival rate of the entire group. Patients were censored at last known followup. The dotted curves represent the 95% confidence interval. The disease-free survival rate of the entire group was 29%.
Fig. 4
Fig. 4
The cumulative incidence of recurrence is represented over time with death as a competing risk. The dotted curves represent the 95% confidence intervals. The cumulative incidence of recurrence rate was 34%, and they all occurred within 3 years after surgery. Tumor location and tumor size of 10 cm or greater were major risk factors for development of local recurrence.
Fig. 5
Fig. 5
The cumulative incidence of metastasis is represented with death as a competing risk factor. The dotted curves represent the 95% confidence intervals. The cumulative incidence rate of metastasis was 48%, and the majority occurred within 3 years. An inadequate margin and tumor size of 10 cm or greater were major risk factors for development of metastasis.
See this image and copyright information in PMC

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1200/JCO.20.3.776', 'is_inner': False, 'url': 'https://doi.org/10.1200/jco.20.3.776'}, {'type': 'PubMed', 'value': '11821461', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/11821461/'}]}
    2. Bielack SS, Kempf-Bielack B, Delling G, Exner GU, Flege S, Helmke K, Kotz R, Salzer-Kuntschik M, Werner M, Winkelmann W, Zoubek A, Jurgens H, Winkler K. Prognostic factors in high-grade osteosarcoma of the extremities or trunk: an analysis of 1,702 patients treated on neoadjuvant cooperative osteosarcoma study group protocols. J Clin Oncol. 2002;20:776–790. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1002/mpo.2950240103', 'is_inner': False, 'url': 'https://doi.org/10.1002/mpo.2950240103'}, {'type': 'PubMed', 'value': '7968796', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/7968796/'}]}
    2. Bielack SS, Wulff B, Delling G, Gobel U, Kotz R, Ritter J, Winkler K. Osteosarcoma of the trunk treated by multimodal therapy: experience of the Cooperative Osteosarcoma study group (COSS). Med Pediatr Oncol. 1995;24:6–12. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '1652313', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/1652313/'}]}
    2. Campanacci M, Ruggieri P. Osteosarcoma. Bull Hosp Jt Dis Orthop Inst. 1991;51:1–11. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/j.ejso.2003.12.004', 'is_inner': False, 'url': 'https://doi.org/10.1016/j.ejso.2003.12.004'}, {'type': 'PubMed', 'value': '15028318', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15028318/'}]}
    2. Donati D, Giacomini S, Gozzi E, Ferrari S, Sangiorgi L, Tienghi A, DeGroot H, Bertoni F, Bacchini P, Bacci G, Mercuri M. Osteosarcoma of the pelvis. Eur J Surg Oncol. 2004;30:332–340. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '701308', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/701308/'}]}
    2. Enneking WF, Dunham WK. Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am. 1978;60:731–746. - PubMed

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