Prognostic value of histologic tumor necrosis assessment in osteogenic sarcoma of bone

To assess the prognostic value of tumor necrosis in osteogenic sarcoma of bone, we designed a retrospective study of 18 patients with classic osteogenic sarcoma (OGS) in which several factors were considered as the common criteria of inclusion. Forty percent of patients with > or = 95% necrosis related to chemotherapy of their primary tumor experienced metastatic disease and/or tumor recurrence during their follow-up, while 50% of those with < 95% necrosis had a disease-free period of > or = 5 years. Tumor necrosis related to chemotherapy in OGS does not seem to represent, as a single predictor of disease-free survival, an accurate clinical prognostic indicator. Further clinical and epidemiologic studies are needed on larger series of patients with strict criteria of inclusion to confirm our results.