title: Relationship between height at diagnosis and bone tumours in young people: a meta-analysis.
abstract: OBJECTIVE
  Some evidence exists that patients with osteosarcoma and Ewing sarcoma are taller than the general population. However, previous studies are under-powered, lack comprehensive data and show inconsistencies.
  
  
  METHODS
  Relevant studies linking osteosarcoma and Ewing sarcoma with height at diagnosis were identified in two major online databases, Medline (1950 to 2009) and Embase (1980 to 2009). Outcomes in individual studies were reported as standard deviation (SD) scores or percentages of study population with height at diagnosis above the median of the reference population. We performed separate random-effects meta-analyses for each outcome and tumour type.
  
  
  RESULTS
  14 studies examined the height of patients with osteosarcoma or Ewing sarcoma. Meta-analyses on SD scores found patients with osteosarcoma were 0.260 SD (95% CI: 0.088-0.432) taller than the reference population (five studies). A meta-analysis on percentages found 62% (95% CI: 57%-67%) of patients were estimated to have a height above the median (six studies). Patients with Ewing sarcoma were 0.096 SD (95% CI 0.004-0.188) taller (four studies). Only one study reported the percentage of Ewing sarcoma patients with height above the median.
  
  
  CONCLUSIONS
  The average height of patients with osteosarcoma, but not Ewing sarcoma, was significantly above the average height of the reference population by 2-3 centimetres. The observed differences indicate the involvement of pubertal longitudinal bone growth in osteosarcoma development while different biological pathways could be relevant for Ewing sarcoma.
authors.affiliation: Cancer Research UK Paediatric and Familial Cancer Research Group, 1.906, University of Manchester, Stopford Building, Oxford Road, M13 9PL Manchester, UK. reemaraman@doctors.org.uk
authors.forename: Ramandeep S
authors.initials: RS
authors.lastname: Arora
authors.forename: Evangelos
authors.initials: E
authors.lastname: Kontopantelis
authors.forename: Robert D
authors.initials: RD
authors.lastname: Alston
authors.forename: Tim O
authors.initials: TO
authors.lastname: Eden
authors.forename: Marco
authors.initials: M
authors.lastname: Geraci
authors.forename: Jillian M
authors.initials: JM
authors.lastname: Birch
mesh_terms: D000293:Adolescent; D001827:Body Height; D001859:Bone Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012516:Osteosarcoma / Q000175:diagnosis / Q000453:epidemiology*; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult