Prognostic effect of pathologic fracture in localized osteosarcoma: a cohort/case controlled study at a single institute.
BACKGROUND
The negative prognostic role of pathologic fracture in osteosarcoma is not determined, as previous case-control and retrospective cohort studies have produced contradictory results.


METHODS
We conducted both cohort (n = 384) and case-control (n = 111) studies on 37 pathologically fractured localized osteosarcoma of extremity.


RESULTS
In cohort study, patients with a fracture showed a tendency of poorer survival, but the difference did not reach the level of significance (5-year metastasis-free survival rates; 48% for cases vs. 61% for controls; P = 0.06). A case-control study on 37 fractured and 74 control recruited from 347 patients matched for tumor size and location showed no survival difference between the cases and controls (P = 0.12).


CONCLUSIONS
Reported negative prognostic effect of a pathologic fracture is likely to be due to confounding by tumor size and location. The present study suggests that the presence of a pathologic fracture has no prognostic relevance.
Kim
Min S
MS
Department of Pathology, Korea Cancer Center Hospital, Seoul 139-706, Korea.
Lee
Soo-Yong
SY
Lee
Tae R
TR
Cho
Wan H
WH
Song
Won S
WS
Cho
Sang H
SH
Lee
Jun A
JA
Yoo
Ji Y
JY
Jung
Sung T
ST
Jeon
Dae-Geun
DG
D000293:Adolescent; D001859:Bone Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012516:Osteosarcoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D016019:Survival Analysis