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Japanese Journal of Clinical Oncology Advance Access published online on November 5, 2009
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyp131
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© The Author (2009). Published by Oxford University Press. All rights reserved

Osteosarcoma of the Flat Bone

Jun Ah Lee1, Min Suk Kim2, Jae-Soo Koh2, Mi Sook Kim3, Dong Ho Kim1, Jung Sub Lim1, Chang-Bae Kong4, Won Seok Song4, Wan Hyeong Cho4, Soo-Yong Lee4 and Dae-Geun Jeon4

1 Department of Pediatrics, Korea Cancer Center Hospital
2 Department of Pathology, Korea Cancer Center Hospital
3 Department of Radiation Oncology, Korea Cancer Center Hospital
4 Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Republic of Korea

For reprints and all correspondence: Dae-Geun Jeon, Department of Orthopedic Surgery, Korea Cancer Center Hospital, 215-4 Gongneung-Dong, Nowon-Gu, 139-706 Seoul, Republic of Korea. E-mail: dgjeon{at}kcch.re.kr

Received June 11, 2009; accepted September 12, 2009

Objective: We aimed to understand the biology of osteosarcoma of the flat bone, which is a rare tumor entity.

Methods: Cases with osteosarcoma of the flat bone were compared with those of the extremity in order to evaluate their clinicopathologic characteristics. And the influences of heterogeneous treatment modalities on outcome were analyzed.

Results: Tumors of the flat bone comprised 91 (11.3%) of 806 osteosarcoma cases. Eight cases were secondary osteosarcoma associated with previous radiotherapy. Patients with a flat bone tumor were significantly older and more likely to present with metastases at diagnosis than extremity tumor. The proportions of female sex and chondroblastic subtype were higher among flat bone tumors than among extremity tumors. The 5-year overall survival and event-free survival rates were 35.2 ± 5.4% and 24.7 ± 5.5%, respectively. Although age and histologic response to pre-operative chemotherapy were not related to outcome of flat bone tumors, treatment modality influenced the survival. Patients treated surgically had better outcomes than those treated by another means. Radiation therapy did not appear to be an effective local control measure as surgery.

Conclusions: Treatment outcome of the tumor of the flat bone was worse than extremity tumors. Further studies are needed to identify effective local control measures that can substitute for surgery and to determine the biologic characteristics of osteosarcoma of the flat bone.

Key Words: osteosarcoma • flat bone • characteristics • treatment • outcome


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