Osteosarcoma of the pelvis.

Area of Science:

• Orthopedic Oncology
• Skeletal Tumors
• Cancer Research

Background:

• Pelvic osteosarcoma presents unique treatment challenges due to late presentation, large size, and frequent metastases.
• Chondroid origin and chemotherapy resistance contribute to the difficulty in managing pelvic osteosarcoma.

Purpose of the Study:

• To review the management of pelvic osteosarcoma patients.
• To identify prognostic factors for poor outcomes in pelvic osteosarcoma.

Main Methods:

• A retrospective review of 121 patients treated between 1983 and 2014.
• Analysis included primary and secondary osteosarcomas (Paget's disease, post-irradiation).
• Data collected on patient demographics, tumor characteristics, and survival outcomes.

Main Results:

• Overall five-year disease-specific survival was 27.2%.
• Patients with metastases at diagnosis had a five-year survival of 32.7%.
• Metastases at diagnosis and secondary tumors were associated with poor outcomes. Primary tumors with sacral location, >10 cm diameter, or intralesional margins also indicated poor prognosis.

Conclusions:

• Secondary pelvic osteosarcomas and those presenting with metastases have a particularly poor prognosis.
• For primary pelvic osteosarcomas, sacral location, large tumor diameter (>10 cm), and intralesional surgical margins are poor prognostic indicators.