Kim Min S, Lee Soo-Yong, Lee Tae R, Cho Wan H, Song Won S, Cho Sang H, Lee Jun A, Yoo Ji Y, Jung Sung T, Jeon Dae-Geun
Department of Pathology, Korea Cancer Center Hospital, Seoul 139-706, Korea.
J Surg Oncol. 2009 Sep 1;100(3):233-9. doi: 10.1002/jso.21265.
The negative prognostic role of pathologic fracture in osteosarcoma is not determined, as previous case-control and retrospective cohort studies have produced contradictory results.
We conducted both cohort (n = 384) and case-control (n = 111) studies on 37 pathologically fractured localized osteosarcoma of extremity.
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).
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.
骨肉瘤中病理性骨折的负面预后作用尚未确定，因为之前的病例对照研究和回顾性队列研究得出了相互矛盾的结果。
我们对37例肢体局部骨肉瘤病理性骨折患者进行了队列研究（n = 384）和病例对照研究（n = 111）。
在队列研究中，骨折患者有生存较差的趋势，但差异未达到显著水平（5年无转移生存率；病例组为48%，对照组为61%；P = 0.06）。一项病例对照研究对从347例患者中招募的37例骨折患者和74例对照进行了肿瘤大小和位置匹配，结果显示病例组和对照组之间无生存差异（P = 0.12）。
报道的病理性骨折的负面预后作用可能是由于肿瘤大小和位置的混杂因素所致。本研究表明病理性骨折的存在与预后无关。
