Sireesha Yedururi1, Sumedha Chawla2, Behrang Amini3, Wei Wei4, Usama I Salem5, Ajaykumar C Morani6, Wei-Lien Wang7, Richard Gorlick8, Valerae O Lewis9, Najat C Daw10. 1. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 1473, Houston, TX, 77030, United States. Electronic address: syedururi@mdanderson.org. 2. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 1473, Houston, TX, 77030, United States. Electronic address: sumedha.chawla@alumni.uth.edu. 3. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 1473, Houston, TX, 77030, United States. Electronic address: bamini@mdanderson.org. 4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 1411, Houston, TX, 77030, United States. Electronic address: wwei@mdanderson.org. 5. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 1473, Houston, TX, 77030, United States. Electronic address: ussalem@UTMB.EDU. 6. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 1473, Houston, TX, 77030, United States. Electronic address: amorani@mdanderson.org. 7. Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 0085, Houston, TX, 77030, United States. Electronic address: wlwang@mdanderson.org. 8. Division of Pediatrics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 0087, Houston, TX, 77030, United States. Electronic address: rgorlick@mdanderson.org. 9. Department of Orthopedic Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 1448, Houston, TX, 77030, United States; Pelvic Sarcoma Center of Excellence, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 1448, Houston, TX, 77030, United States. Electronic address: volewis@mdanderson.org. 10. Division of Pediatrics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Street, Unit 0087, Houston, TX, 77030, United States. Electronic address: ndaw@mdanderson.org.
Abstract
PURPOSE: To evaluate the frequency of tumor thrombus in the large veins draining primary pelvic osteosarcoma on early cross-sectional imaging studies and its effect on patient survival. MATERIALS AND METHODS: Our retrospective study included all patients with primary pelvic osteosarcoma treated at our facility between January 2000 and May 2014, who were ≤ 45 years of age, and had adequate imaging studies and clinical follow up. Four radiologists evaluated for tumor in the large draining veins on initial CT, MRI and PET/CTs. A consensus evaluation by the four radiologists together with findings on operative reports, pathology reports or follow-up imaging was used as the reference standard. RESULTS: Thirty-nine patients with primary pelvic osteosarcoma met final inclusion criteria. Tumor thrombus was identified in the large draining veins in 10 of the 22 (45%) patients who underwent tumor resection and 10 of the 17 (59%) who did not. In the 22 patients who underwent tumor resection, tumor thrombus was significantly associated with worse overall survival (p = 0.03). CONCLUSIONS: Tumor thrombus in the large draining veins is identified in a significant proportion of initial imaging studies in patients with pelvic osteosarcoma, and is associated with worse overall survival in patients who undergo tumor resection.
PURPOSE: To evaluate the frequency of tumor thrombus in the large veins draining primary pelvic osteosarcoma on early cross-sectional imaging studies and its effect on patient survival. MATERIALS AND METHODS: Our retrospective study included all patients with primary pelvic osteosarcoma treated at our facility between January 2000 and May 2014, who were ≤ 45 years of age, and had adequate imaging studies and clinical follow up. Four radiologists evaluated for tumor in the large draining veins on initial CT, MRI and PET/CTs. A consensus evaluation by the four radiologists together with findings on operative reports, pathology reports or follow-up imaging was used as the reference standard. RESULTS: Thirty-nine patients with primary pelvic osteosarcoma met final inclusion criteria. Tumor thrombus was identified in the large draining veins in 10 of the 22 (45%) patients who underwent tumor resection and 10 of the 17 (59%) who did not. In the 22 patients who underwent tumor resection, tumor thrombus was significantly associated with worse overall survival (p = 0.03). CONCLUSIONS:Tumor thrombus in the large draining veins is identified in a significant proportion of initial imaging studies in patients with pelvic osteosarcoma, and is associated with worse overall survival in patients who undergo tumor resection.
Authors: Andreas F Mavrogenis; Andrea Angelini; Vasileios I Sakellariou; Evangelia Skarpidi; Pietro Ruggieri; Panayiotis J Papagelopoulos Journal: J Surg Orthop Adv Date: 2012
Authors: Sireesha Yedururi; Ajaykumar C Morani; Gregory W Gladish; Srilakshmi Vallabhaneni; Peter M Anderson; Dennis Hughes; Wei-Lien Wang; Najat C Daw Journal: Pediatr Radiol Date: 2015-09-28