Treatment and outcome of parosteal osteosarcoma: biological versus endoprosthetic reconstruction.
OBJECTIVE
Due to its good prognosis despite local recurrence, more and less invasive methods for surgical treatment of parosteal osteosarcoma (POS) have been described. Aim of this retrospective single-center study was to investigate differences in outcome after biological and prosthetic reconstruction.


METHODS
A total of 28 patients with POS, 14 females, 14 males, mean age of 27 years (median, 24 years; range 15-59 years), mean follow-up of 130 months (median, 104 months; range, 9-383 months), underwent wide tumor resection and prosthetic reconstruction (12 patients, 42.9%), less extensive resection and biological reconstruction (11 patients, 39.3%), rotationplasty (three patients, 10.7%), or amputation (two patients, 7.1%).


RESULTS
There were two cases of local recurrence in patients with biological reconstruction and three cases of pulmonary metastases, leading to death of disease in two. Ten-year disease-specific survival was 91.1%. There was no significant difference between prosthetic and biological reconstruction in terms of local recurrence, metastasis, or functional outcome (mean MSTS Score, 85%). There were significantly more revisions in prosthetic reconstructions.


CONCLUSIONS
Given that the resection of the tumor has clear margins, both prosthetic and biological reconstruction show similar results; prostheses allow better local tumor control, however, require more revisions over time.
Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria. philipp.funovics@meduniwien.ac.at
Philipp T
PT
Funovics
Frederik
F
Bucher
Cyril D
CD
Toma
Rainer I
RI
Kotz
Martin
M
Dominkus
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D001859:Bone Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D016025:Bone Transplantation; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D012516:Osteosarcoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D010521:Periosteum / Q000473:pathology* / Q000601:surgery; D019736:Prostheses and Implants; D012189:Retrospective Studies; D055815:Young Adult