A comparison of intramedullary and juxtacortical low-grade osteogenic sarcoma.
While low-grade juxtacortical and low-grade intramedullary osteogenic sarcomas are histologically indistinguishable, they have been studied as separate entities. We retrospectively reviewed the clinical, radiographic, histologic features and treatment of 59 patients treated surgically to compare the rate of local recurrence, grade progression, and survival between low-grade intramedullary and low-grade juxtacortical osteogenic sarcoma. Forty-five (76%) patients were treated for low-grade juxtacortical osteogenic sarcoma and 14 (24%) were treated for low-grade intramedullary osteogenic sarcoma. Local recurrence rates of 7% were similar for both groups studied. The rate of distant metastases was also similar for both groups. . The rate of dedifferentiation for the entire group was 29%. Dedifferentiated lesions were treated with adjuvant chemotherapy in 16 of 17 cases. Recurrence preceded dedifferentiation in four cases. Five-year survival was over 90% in both groups. Low-grade intramedullary and low-grade juxtacortical osteogenic sarcoma were clinically indistinguishable with identical rates of local recurrence, distant metastases, dedifferentiation, and survival.


METHODS
Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Schwab
Joseph H
JH
Department of Surgery/Section of Orthopedics, Memorial Sloan Kettering Cancer, Weill Cornell Medical School, 1275 York Avenue, New York, NY 10021, USA.
Antonescu
Cristina R
CR
Athanasian
Edward A
EA
Boland
Patrick J
PJ
Healey
John H
JH
Morris
Carol D
CD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D002648:Child; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018217:Osteosarcoma, Juxtacortical / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome