Comparative Analysis Between Osteosarcoma and Ewing's Sarcoma: Evaluation of the Time From Onset of Signs and Symptoms Until Diagnosis

Guerra, Raquel Bezerra; Tostes, Marcelo Duarte; Miranda, Leandro da Costa; Camargo, Olavo Pires de; Baptista, André Mathias; Caiero, Marcelo Tadeu; Machado, Telma Muria dos Santos; Abadi, Márcia Datz; Oliveira, Cláudia de; Filippi, Renée Zon

doi:10.1590/s1807-59322006000200003

Cited by 32 publications

(34 citation statements)

References 17 publications

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“…This study focused on the potential impact of two time intervals on the survival of children diagnosed with osteosarcoma who were treated in an LMIC. Our findings reveal that the median LD was longer than that observed in HIC and was comparable to reported times in other LMIC . Initial metastatic disease was found in 42.4% of patients; however, we failed to associate this finding with a delayed LD, which is similar to published data .…”

Section: Discussionsupporting

confidence: 87%

“…Our findings reveal that the median LD was longer than that observed in HIC 8,10,13,[23][24][25] and was comparable to reported times in other LMIC. 26,27 Initial metastatic disease was found in 42.4% of patients; however, we failed to associate this finding with a delayed LD, which is similar to published data. [8][9][10][11] An aggressive tumor biology was likely associated with rapid progression and advanced presentation.…”

Section: Discussionsupporting

confidence: 84%

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Prognostic impact of diagnostic and treatment delays in children with osteosarcoma

Vásquez

Silva

Chávez

et al. 2020

Pediatric Blood & Cancer

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Background The aim of this study is to evaluate the relationship between the latency to diagnosis (LD) and the time to completion of chemotherapy (TCC) with clinical outcomes in children with osteosarcoma. Methods We performed a retrospective analysis of all patients who received treatment for osteosarcoma in two tertiary centers in Peru from 2008 to 2015. All causes of delayed LD or TCC were evaluated. Overall survival (OS) and event‐free‐survival (EFS) were estimated and compared according to LD, TCC, and established clinical prognostic factors. Results One hundred and thirteen patients were included in the study. The median LD was 13.5 weeks (interquartile range, 10‐18.5 weeks). No association was observed among clinical stage, tumor size, and LD. Delayed LD was not associated with a worse clinical outcome. Multivariate analysis confirmed that OS and EFS were significantly worse in cases of a delayed TCC (≥4 weeks), with hazard ratios of 2.70 (1.11‐6.76, P = 0.003) and 1.13 (1.00‐1.26, P = 0.016), respectively. Most delays in TCC (85%) were due to extramedical reasons (e.g., lack of available hospital beds). Conclusion The LD did not seem to influence the EFS and OS in pediatric patients with osteosarcoma. However, a delay in TCC from any cause is independently associated with poor outcome in pediatric patients with osteosarcoma. Based on these results, further efforts may be needed to avoid treatment delays in patients with osteosarcoma in middle‐income countries.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 84%

Prognostic impact of diagnostic and treatment delays in children with osteosarcoma

Vásquez

Silva

Chávez

et al. 2020

Pediatric Blood & Cancer

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“…The distal femur is a far more frequently affected site compared to the diaphyseal femur: 44% and 3%, respectively [2]. In terms of size, the lesion in the distal femur of our patient had progressed much more than the lesions in the fracture fragments (Figure 5B).…”

Section: Discussionmentioning

confidence: 69%

“…Guerra et al . [2] reported 20 such cases (11.4%) of 175 total patients in their series. The pathological nature of the fracture is commonly recognized on the basis of radiological signs.…”

Section: Introductionmentioning

confidence: 99%

Osteosarcoma in the distal femur two years after an ipsilateral femoral shaft fracture: a case report

Dorrestijn

Jutte

2011

J Med Case Reports

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IntroductionThe duration of symptoms preceding a definitive diagnosis of osteosarcoma is quite long. Pathological radiological signs are often evident by the time of diagnosis. Although several case reports have been published on osteosarcoma of the femur, to the best of our knowledge this report is the first one with such an unusual clinical course.Case presentationWe describe the case of a 58-year-old Caucasian man who presented with a femoral shaft fracture. Two years post-trauma osteosarcoma in the ipsilateral distal femur was diagnosed. Was it coincidence? We think that the history of the trauma is crucial to answering this question.ConclusionThis case report underlines the need to keep up awareness of pathological fractures in emergency medicine and trauma surgery. When radiographs do not raise any suspicion but the history of trauma or the physical examination does, we recommend further radiological and/or histological diagnostic examinations.

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“…15 Guerra et al showed that the patients with osteosarcoma or Ewing's sarcoma present local pain most frequently (89.5% of the time) as an early symptom. 9 The time interval between the onset of signs and symptoms and diagnosis observed for osteosarcoma was 5.25 months and Ewing's sarcoma it was 8.1 months. 9 According to review of literature the osteosarcoma and Ewing's sarcoma presenting symptoms are pain, swelling, weight loss, and pathological fracture.…”

Section: Discussionmentioning

confidence: 95%

Malignant Tumors of Foot: What Are the Outcomes?

Salunke¹,

Shah²,

Pandit³

et al. 2018

J. Musculoskelet. Res.

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Introduction: We have analyzed the clinical features and outcomes of malignant tumors of foot. Methods: Between January 2010 to January 2017, 21 patients of malignant tumors of calcaneum and talus were treated. These included 14 cases of osteosarcoma, 7 cases of Ewing’s sarcoma. Talus was involved in 8 cases and calcaneum involved in 11 cases. Mean follow-up for all patients was 30 months (range 24–70 months). Results: In osteosarcoma of calcaneum and talus the presenting symptom was local pain in 63% and swelling in 37%. Patients with Ewing’s sarcoma presented with swelling in 100% cases. The mean delay in diagnosis for osteosarcoma and Ewing’s sarcoma was 8.8 months (range 6–12 months) and 9.5 months (range 6–12 months), respectively. Patients with delay in diagnoses of more than six months and less than six months had disease free survival of 11.5 months and 15 months, respectively and [Formula: see text] value 0.3. Patients with delay in diagnoses of more than six months and less than six months had metastases in 5 and 1cases, respectively. The mean disease free interval (DFI) for osteosarcoma and Ewing’s sarcoma was 16 months and 5.5 months, respectively. The correlation between osteosarcoma and Ewing’s sarcoma of calcaneum and foot with delay in diagnosis and DFI did not reach statistical significance ([Formula: see text] value 0.93 and 0.14, respectively). Conclusion: An index of suspicion, proper examination with close scrutiny of the radiographs is required in patients presenting malignant of bones of foot. Osteosarcoma of calcaneum and talus most commonly presented with local pain and Ewing’s sarcoma present with swelling. The time interval between the onset of symptoms and diagnosis (delay in diagnosis) for calcaneum and talus osteosarcoma was similar to Ewing’s sarcoma.

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Comparative Analysis Between Osteosarcoma and Ewing's Sarcoma: Evaluation of the Time From Onset of Signs and Symptoms Until Diagnosis

Cited by 32 publications

References 17 publications

Prognostic impact of diagnostic and treatment delays in children with osteosarcoma

Prognostic impact of diagnostic and treatment delays in children with osteosarcoma

Osteosarcoma in the distal femur two years after an ipsilateral femoral shaft fracture: a case report

Malignant Tumors of Foot: What Are the Outcomes?

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