Clinical Orthopaedics and Related Research

, Volume 467, Issue 2, pp 510–518 | Cite as

Osteosarcoma of the Pelvis: Outcome Analysis of Surgical Treatment

  • Bruno Fuchs
  • Nathan Hoekzema
  • Dirk R. Larson
  • Carrie Y. Inwards
  • Franklin H. Sim
Original Article


Risk factors to explain the poor survival of patients with osteosarcoma of the pelvis are poorly understood. Therefore, we attempted to identify factors affecting survival and development of local recurrence and metastasis. We retrospectively reviewed 43 patients who had high-grade pelvic tumors and were treated surgically. Twenty lesions were chondroblastic, 10 fibroblastic, 11 osteoblastic, and one each was giant cell-rich and small cell osteosarcomas. At a median of 3.5 years (range, 0.3–21 years) postoperatively, 13 patients were alive with no evidence of disease. The overall and disease-free 5-year survival rates were 38% and 29%, respectively, at 5 years. Anatomic location, tumor size, and margin predicted survival. Fifteen patients (35%) had local recurrence. The 5-year cumulative incidence of recurrence with death as a competing risk factor was 34%. Location in the ilium and size of the tumor predicted local recurrence. Twenty-one (49%) of 43 patients had metastases develop. The cumulative incidence of metastasis with death as a competing risk factor was 48% at 5 years. Six patients who presented with metastasis had a worse survival than patients who had no evidence of metastasis at presentation (2-year survival, 33% versus 76%). If distant metastasis is diagnosed subsequent to primary treatment, aggressive therapy may be justified.

Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.


Local Recurrence Osteosarcoma Fibrous Dysplasia Sacroiliac Joint Adequate Margin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Bruno Fuchs
    • 1
  • Nathan Hoekzema
    • 2
  • Dirk R. Larson
    • 3
  • Carrie Y. Inwards
    • 4
  • Franklin H. Sim
    • 2
  1. 1.Division of Orthopedic Oncology, Department of OrthopedicsBalgrist University Hospital, University of ZurichZurichSwitzerland
  2. 2.Division of Orthopedic OncologyMayo ClinicRochester USA
  3. 3.Department of BiostatisticsMayo ClinicRochesterUSA
  4. 4.Department of Surgical PathologyMayo ClinicRochester USA

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