BACKGROUND: In osteosarcoma, as in other tumors, the presence of metastases at presentation is generally considered a consequence of late diagnosis. To verify this, the authors investigated whether there was a relationship between the stage of the disease at presentation and several clinical and pathologic characteristics, including the interval between the onset of first symptoms or signs and the final diagnosis. PATIENTS AND METHODS: One thousand seventy-one patients with high-grade osteosarcoma of the extremity were observed between 1980 and 1999. Of these, 891 had a localized tumor and 180 had metastases at the time of diagnosis. RESULTS: Compared with patients with localized disease, patients with detectable metastases at the time of diagnosis had higher serum levels of alkaline phosphatase, larger primary lesions, and tumors often located in the femur and humerus. In terms of time to diagnosis, the interval between the onset of first symptoms and the final diagnosis was significantly shorter in patients with metastases than in patients with localized tumor. This surprising finding probably reflects a more rapid growth of the tumor. CONCLUSIONS: These results suggest a different biologic phenotype and aggressiveness of the tumor in a subgroup of patients and that the stage of the disease at presentation depends more on the properties of these tumors than on late diagnosis.
BACKGROUND: In osteosarcoma, as in other tumors, the presence of metastases at presentation is generally considered a consequence of late diagnosis. To verify this, the authors investigated whether there was a relationship between the stage of the disease at presentation and several clinical and pathologic characteristics, including the interval between the onset of first symptoms or signs and the final diagnosis. PATIENTS AND METHODS: One thousand seventy-one patients with high-grade osteosarcoma of the extremity were observed between 1980 and 1999. Of these, 891 had a localized tumor and 180 had metastases at the time of diagnosis. RESULTS: Compared with patients with localized disease, patients with detectable metastases at the time of diagnosis had higher serum levels of alkaline phosphatase, larger primary lesions, and tumors often located in the femur and humerus. In terms of time to diagnosis, the interval between the onset of first symptoms and the final diagnosis was significantly shorter in patients with metastases than in patients with localized tumor. This surprising finding probably reflects a more rapid growth of the tumor. CONCLUSIONS: These results suggest a different biologic phenotype and aggressiveness of the tumor in a subgroup of patients and that the stage of the disease at presentation depends more on the properties of these tumors than on late diagnosis.
Authors: Luciana N O Miiji; Antonio S Petrilli; Sebastian Di Cesare; Alexandre N Odashiro; Miguel N Burnier; Silvia R de Toledo; Reynaldo Jesus Garcia; Maria Teresa S Alves Journal: Int J Clin Exp Pathol Date: 2011-11-03
Authors: Antonieta Medina-Lara; Bogdan Grigore; Ruth Lewis; Jaime Peters; Sarah Price; Paolo Landa; Sophie Robinson; Richard Neal; William Hamilton; Anne E Spencer Journal: Health Technol Assess Date: 2020-11 Impact factor: 4.014
Authors: R D Neal; P Tharmanathan; B France; N U Din; S Cotton; J Fallon-Ferguson; W Hamilton; A Hendry; M Hendry; R Lewis; U Macleod; E D Mitchell; M Pickett; T Rai; K Shaw; N Stuart; M L Tørring; C Wilkinson; B Williams; N Williams; J Emery Journal: Br J Cancer Date: 2015-03-31 Impact factor: 7.640