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Differential Presentations, Clinical Courses, and Survivals of Osteosarcomas of the Proximal Humerus over Other Extremity Locations

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Although there are controversies about the prognosis of proximal humeral osteosarcoma, our previous study showed poor survival in those patients. In the present study, we undertook to determine why this site is associated with a poor outcome and to identify the clinicopathologic variables involved.

Methods

The study cohort consisted of 36 proximal humeral and 341 other extremity American Joint Committee on Cancer (AJCC) stage II osteosarcomas. We examined the clinicopathologic differences between these osteosarcomas. The prognostic significances of factors identified for a proximal humoral location were evaluated by survival analysis of all 377 patients.

Results

Patients with a proximal humeral osteosarcoma had the following characteristics: a higher incidence of pathologic fracture (P < 0.01), an osteolytic pattern on plain radiographs (P < 0.01), an unusual pathological subtype (P = 0.01), poor histologic response (P < 0.01), and an increased tumor-volume ratio (TVR) (P < 0.01). Multivariate analysis revealed that a large tumor volume (P < 0.01), an increase in tumor volume (P < 0.01), and a poor histologic response to preoperative chemotherapy (P < 0.01) independently predicted shorter metastasis-free survival.

Conclusions

The association between proximal humeral osteosarcoma and poor survival could be the result of unresponsiveness to chemotherapy, which was expressed by a tumor volume increase in our patients.

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Authors and Affiliations

  1. Departments of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea

    Wan Hyeong Cho MD, Won Seok Song MD, Dae-Geun Jeon MD, Chang-Bae Kong MD & Soo-Yong Lee MD

  2. Departments of Pathology, Korea Cancer Center Hospital, Seoul, Korea

    Min Suk Kim MD

  3. Departments of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea

    Jun Ah Lee MD

  4. Department of Radiology, Korea Cancer Center Hospital, Seoul, Korea

    Ji Young Yoo MD

  5. Department of Orthopedic Surgery, Kosin University Medical School, Pusan, Korea

    Jae Do Kim MD

Authors
  1. Wan Hyeong Cho MD
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  2. Won Seok Song MD
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  3. Dae-Geun Jeon MD
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  4. Chang-Bae Kong MD
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  5. Min Suk Kim MD
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  6. Jun Ah Lee MD
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  7. Ji Young Yoo MD
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  8. Jae Do Kim MD
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  9. Soo-Yong Lee MD
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Corresponding author

Correspondence to Dae-Geun Jeon MD.

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Cho, W.H., Song, W.S., Jeon, DG. et al. Differential Presentations, Clinical Courses, and Survivals of Osteosarcomas of the Proximal Humerus over Other Extremity Locations. Ann Surg Oncol 17, 702–708 (2010). https://doi.org/10.1245/s10434-009-0825-6

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  • DOI: https://doi.org/10.1245/s10434-009-0825-6

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