This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Daecke, W. Articles by Bernd, L. Search for Related Content PubMed PubMed Citation Articles by Daecke, W. Articles by Bernd, L.

Osteosarcoma of the Hand and Forearm: Experience of the Cooperative Osteosarcoma Study Group

¹ Department of Hand Surgery, University of Heidelberg, Schlierbacher Landstrasse 200, 69118 Heidelberg, Germany
² Department of Orthopedic Surgery, University of Heidelberg, Schlierbacher Landstrasse 200, 69118 Heidelberg, Germany
³ Department of Pediatric Hematology and Oncology, University Children’s Hospital Münster, Albert-Schweitzer-Strasse 33, 48149 Münster, Germany
⁴ Department of Orthopedic Surgery, University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
⁵ Department of Orthopedic Surgery, University of Münster, Albert-Schweitzer-Strasse 33, 48149 Münster, Germany
⁶ University Children’s Hospital, Martinistrasse 52, 20246 Hamburg, Germany

Correspondence: Address correspondence and reprint requests to: Wolfgang Daecke, MD, Cooperative Osteosarkomstudiengruppe, Universitätsklinikum Münster, Klinik und Poliklinik für Kinder- und Jugendmedizin, Pädiatrische Hämatologie und Onkologie, Albert-Schweitzer-Strasse 33, D-48149, Münster, Germany; E-mail: coss{at}uni-muenster.de.

Background: Osteosarcoma is extremely rare in the hand and forearm. Therefore, only limited data are available for planning treatment or predicting the outcome and prognosis of osteosarcoma in the peripheral upper extremity.

Methods: Epidemiological, clinical, and histopathologic data were analyzed in 39 patients with osteosarcoma of the forearm or hand who were enrolled in studies of the Cooperative German-Austrian-Swiss Osteosarcoma Study Group from 1977 to December 2000. In patients with high-grade osteosarcoma, the treatment entailed surgical resection in combination with chemotherapy, whereas patients with low-grade osteosarcoma underwent only surgery.

Results: The 5-year overall survival rate among the 33 patients with high-grade central osteosarcoma of the distal upper extremity was 86.2% ± 6.4% . The 5-year event-free survival rate was 65.4% ± 9.6% . Five of the eight patients with secondary metastases were in remission at the time of analysis. Four patients died of their disease, and two patients died of chemotherapy-related complications. The mean overall survival rate was 88.0% ± 6.5% in patients treated by wide or radical tumor resection and was 75.0% ± 21.7% in patients with nonwide margins of resection. Whether amputation or local resection was performed had no significant influence on the prognosis. All six patients whose osteosarcoma was not classified as high-grade central osteosarcoma were in remission at the time of analysis.

Conclusions: The results demonstrate a remarkably high survival rate for patients with high-grade osteosarcoma of the hand and forearm and confirm that multiagent chemotherapy in combination with wide excision is a highly effective treatment for this malignant tumor.

Key Words: Osteosarcoma • Hand • Forearm • Surgery • Chemotherapy

This article has been cited by other articles:

				M. S. Kim, S.-Y. Lee, T. R. Lee, W. H. Cho, W. S. Song, J.-S. Koh, J. A. Lee, J. Y. Yoo, and D.-G Jeon Prognostic nomogram for predicting the 5-year probability of developing metastasis after neo-adjuvant chemotherapy and definitive surgery for AJCC stage II extremity osteosarcoma Ann. Onc., May 1, 2009; 20(5): 955 - 960. [Abstract] [Full Text] [PDF]