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Surface osteosarcoma: Predictors of outcomes.

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  • 1Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

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|May 27, 2021
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Summary
This summary is machine-generated.

This study on surface osteosarcomas found age to be the only significant predictor of disease progression. Surgical margins and patient age impact outcomes for parosteal osteosarcoma (POS) and periosteal osteosarcoma (PerOS).

Keywords:
clinical outcomessurface osteosarcomasurgical treatmentsystemic treatment

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Area of Science:

  • Orthopedic Oncology
  • Surgical Pathology
  • Cancer Research

Background:

  • Surface osteosarcomas encompass subtypes like parosteal osteosarcoma (POS), periosteal osteosarcoma (PerOS), high-grade surface osteosarcoma (HGSO), and dedifferentiated POS (dPOS).
  • Understanding disease progression, including local recurrence and metastasis, is crucial for these rare bone tumors.

Purpose of the Study:

  • To evaluate disease progression, overall survival (OS), and disease-specific survival (DSS) in patients with surface osteosarcomas.
  • To identify factors predicting outcomes and assess functional results following treatment.

Main Methods:

  • Retrospective analysis of 51 patients with primary surface osteosarcoma treated between 1992 and 2019.
  • Histologic subtyping (POS, PerOS, HGSO, dPOS) and detailed margin classification (AJCC and modified R classification) were performed.
  • Functional outcomes were assessed using the MSTS score.

Main Results:

  • Age was the sole significant predictor of disease progression.
  • Ten-year OS was 97%, with 48 and 47 patients achieving negative bone and soft tissue margins, respectively.
  • Three POS patients recurred, and five developed lung metastases; four patients died.

Conclusions:

  • Surgery is recommended for POS, with R0 or planned R1 margins considered acceptable for function preservation.
  • Combined chemotherapy and surgery are favored for PerOS, acknowledging variable chemotherapeutic responses.
  • HGSO and dPOS subtypes, though infrequent, appear to have poorer prognoses, but good functional outcomes are achievable.