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Prognostic Importance of Pathological Fractures in Osteosarcomas
G A Sheridan1, L Mellon2, E M Thompson1
1Department of Orthopaedics, Cappagh National Orthopaedic Hospital, Dublin, Ireland.
Irish Medical Journal
|April 21, 2020
Summary
Pathological fractures in osteosarcoma patients did not significantly impact survival rates in Ireland. However, fractures were associated with poorer necrosis rates after chemotherapy, warranting further investigation.
Area of Science:
- Orthopaedic Oncology
- Skeletal Oncology
- Cancer Research
Background:
- Osteosarcoma is a primary bone malignancy often affecting younger populations.
- Pathological fractures can complicate osteosarcoma treatment and management.
- Understanding prognostic factors is crucial for improving patient outcomes.
Purpose of the Study:
- To determine if pathological fractures affect the prognosis of osteosarcoma patients in Ireland.
- To identify factors influencing overall survival (OS) and event-free survival (EFS) in osteosarcoma.
Main Methods:
- Retrospective study conducted over 22 years at a National Orthopaedic Oncology Centre.
- Inclusion of 117 non-fracture cases and 15 fracture cases.
- Analysis of 5- and 10-year EFS and OS using Kaplan-Meier curves.
Main Results:
- Pathological fractures showed no significant impact on 10-year EFS or OS.
- American Joint Committee on Cancer (AJCC) classification, metastasis site, and distant recurrence were strongly associated with 10-year OS.
- Fractured cases exhibited poorer post-chemotherapeutic necrosis rates (p=0.005).
Conclusions:
- Pathological fractures do not significantly affect survival rates or survival length in Irish osteosarcoma patients.
- The impact of pathological fractures on necrosis rates requires further research.
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