Prognostic Impact of Proximal Versus Distal Localization in Extremity Long Bone Osteosarcomas

Anticancer Res. 2019 May;39(5):2459-2466. doi: 10.21873/anticanres.13365.


Background/aim: This study aimed to identify the prognostic factors and outcomes of osteosarcoma (OS) located in proximal versus distal extremity long bones.

Patients and methods: A nationwide cohort comprising all Norwegian high-grade OSs in extremity long bones between 1982 and 2009 was investigated.

Results: The univariate analysis results identified no significant differences in survival between patients with OS in proximal long bones (101 cases) as a group in comparison to patients with OS in the distal part of these bones (120 cases). However, proximal femur and primary metastasis were both independent adverse prognostic factors for sarcoma-specific survival in multivariate analyses, while elevated LDH and secondary OS were inferior prognostic factors for event-free survival. Adequate surgery and chemotherapy had a positive impact on survival.

Conclusion: OS of the proximal femur had an unfavorable outcome in comparison to OS in other anatomical locations in extremity long bones.

Keywords: Prognostic factors; osteosarcoma; overall survival; pathological fracture; population-based.

MeSH terms

  • Adolescent
  • Adult
  • Bone Neoplasms / epidemiology*
  • Bone Neoplasms / physiopathology*
  • Cohort Studies
  • Disease-Free Survival
  • Extremities / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Norway
  • Osteosarcoma / epidemiology
  • Osteosarcoma / physiopathology*
  • Prognosis*
  • Young Adult