title: Effect of erroneous surgical procedures on recurrence and survival rates for patients with osteosarcoma.
abstract: To determine whether inappropriate surgical procedures based on an initial misdiagnosis affected recurrence and survival rates, we retrospectively reviewed the surgical treatment and results of 117 patients with high-grade osteosarcomas treated from January 1, 1990 to December 31, 2000. Nine patients had intralesional curettage performed at other institutions based on an erroneous diagnosis of a benign lesion. Two of the nine patients had amputations and seven patients had limb-salvage procedures. Of the 108 patients who were not misdiagnosed, six patients had amputations and 102 patients had limb-salvage procedures. All patients received neoadjuvant therapy. Fifteen of the 117 patients had local recurrences. Patients who had erroneous surgical procedures based on the initial misdiagnosis of osteosarcoma had an increased risk of local recurrence and decreased 10-year survival rate. Response to adjuvant therapy and the amount of previous violation of natural tumor barriers should be evaluated carefully before deciding surgical treatment.
authors.affiliation: Institute of Orthopedics, Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina. miguel.ayerza@hospitalitaliano.org.ar
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Ayerza
authors.forename: D Luis
authors.initials: DL
authors.lastname: Muscolo
authors.forename: Luis A
authors.initials: LA
authors.lastname: Aponte-Tinao
authors.forename: German
authors.initials: G
authors.lastname: Farfalli
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D012516:Osteosarcoma / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate