Prognostic effect of inadvertent curettage without treatment delay in osteosarcoma

Abstract

Unplanned primary surgery has been known to have a negative prognostic impact in osteosarcoma. We identified 20 osteosarcoma patients that had undergone inadvertent surgery followed by adequate treatment without delay, and compared the clinicopathologic characteristics of these 20 case patients with those of 365 patients who underwent incisional biopsy. For survival analysis, 40 control patients matched for tumor size at presentation, tumor location, age and gender were selected from these 365 patients. Unusual initial clinicopathologic characteristics were frequently observed in the case patients, such as, an older age, a small tumor size, an unusual tumor location, and a lytic radiographic pattern. The 5-year overall survival rate in the case group was 89.4 +/- 7.1% and in the control group was 83.9 +/- 6.1%, and the 5-year event-free survival rate in the case group was 90.0 +/- 6.7% and in the control group was 76.8 +/- 6.8%. The log rank test revealed no survival difference between the case and control groups. As is the case for soft tissue sarcoma, inadvertent extensive curettage with no ensuing treatment delay was found to have no detrimental effect on overall- or event-free survival in osteosarcoma. Further study using a larger sample size is needed to confirm our results.