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Clinical Features and Outcomes Differ between Skeletal and Extraskeletal Osteosarcoma.

Sheila Thampi1, Katherine K Matthay1, W John Boscardin2

  • 1Department of Pediatrics, UCSF School of Medicine and UCSF Benioff Children's Hospital, 505 Parnassus Avenue M649, P.O. Box 0106, San Francisco, CA 94143, USA.

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Extraskeletal osteosarcoma (ESOS) is a rare cancer. This study found ESOS patients have distinct features but similar survival factors to bone osteosarcoma, with older patients showing better outcomes.

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Area of Science:

  • Oncology
  • Orthopedic Oncology
  • Cancer Research

Background:

  • Extraskeletal osteosarcoma (ESOS) is a rare malignant bone tumor.
  • Understanding ESOS patient characteristics and survival is crucial for treatment strategies.

Purpose of the Study:

  • To investigate patient demographics, overall survival (OS), and prognostic factors in ESOS.
  • To compare ESOS outcomes with skeletal osteosarcoma, particularly in older patients.

Main Methods:

  • Utilized the Surveillance, Epidemiology, and End Results (SEER) database (1973-2009).
  • Included 4,173 high-grade osteosarcoma cases, with 256 identified as ESOS.
  • Employed univariate and multivariate Cox proportional hazards analyses for survival and prognostic factor assessment.

Main Results:

  • ESOS patients were older, more likely to have axial tumors and lymph node involvement, and were predominantly female.
  • Multivariate analysis indicated ESOS is a favorable diagnosis (HR 0.75, P=0.002) after adjusting for confounders.
  • Older ESOS patients demonstrated superior outcomes compared to older skeletal osteosarcoma patients.

Conclusions:

  • ESOS presents unique clinical features but shares prognostic factors with skeletal osteosarcoma.
  • Age is a significant factor, with older individuals with ESOS experiencing better survival than their skeletal counterparts.
  • Metastatic disease, tumor size, older age, and axial tumor site were identified as adverse prognostic factors in ESOS.