The Journal of the Korean bone and joint tumor society (대한골관절종양학회지)

The Korean Musculoskeletal Tumor Society (대한근골격종양학회)
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Clinical Outcome of Parosteal Osteosarcoma

방골성 골육종의 임상결과

  • Song, Won Seok (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Jeon, Dae-Geun (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Cho, Wan Hyeong (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Kong, Chang Bae (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Cho, Sang Hyun (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Lee, Kwang Ryul (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Lee, Soo-Yong (Department of Orthopedic Surgery, Korea Cancer Center Hospital)
  • Received : 2013.03.25
  • Accepted : 2013.05.20
  • Published : 2013.06.30
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Abstract

Purpose: The purpose of this study was to evaluate the oncologic outcomes of parosteal osteosarcoma (POS) and to ascertain the fates of patients after local recurrence (LR). Materials and Methods: The authors retrospectively reviewed 22 POS patients with an average follow-up of 114 months (range: 36-235 months). Seven of the 22 patients were referred after LR. There were 17 Stage IB and 5 Stage IIB (G2, 2; dedifferentiation, 3). Tumors were located in the femur (11) and in other locations (11). Initial surgical margins were wide in 10, marginal in 5, and intralesional in 7. Correlations between clinico-pathologic variables and LR and clinical courses after LR were evaluated. Results: The 10-year overall survival rate was 85.7%. Three (14%) patients developed distant metastasis and all of them succumbed to the disease. Nine (41%) patients developed LR. Tumor location, resection type, and surgical margin were found to be correlated with LR. At final follow-up, 7 of the 9 patients that experienced local failure achieved no evidence of disease. Conclusion: A substantial risk of misdiagnosis exists, especially for POS in other than a femoral location. Recurrent tumor re-excision is possible in most cases; however, patients with an aggressive recurrence pattern deserve special attention.

목적: 방골성 골육종 환자의 치료 결과와 국소 재발 후의 결과에 대해서 알아보고자 하였다. 대상 및 방법: 22명의 방골성 골육종 환자의 치료 결과를 후향적으로 분석하였다. 평균 추시기간은 114개월(범위; 36-235개월)이었다. 22명 중 7명은 국소 재발 후에 전원 되었다. 병기는 17명에서 IB였고, 5명은 IIB (G2, 2명; 역분화, 3명)이었다. 종양의 위치는 대퇴골(11명), 기타 부위(11명)이었다. 최초 절제연은 광범위 절제연 10명, 변연 절제연 5명, 병소내 절제가 7명이었다. 여러 임상 및 병리인자와 국소 재발과의 연관성, 그리고 국소 재발 후의 임상 경과를 조사하였다. 결과: 10년 생존율은 85.7%이었다. 3명(14%)에서 원격 전이를 보였고 이들은 모두 사망하였다. 9명(41%)에서 국소 재발이 있었다. 종양의 위치, 절제 방법 및 절제연이 국소재발과 관련이 있었다. 국소 재발 후 수술 한 환자 9명 중 최종 추시 시 7명에서는 무병 상태였다. 결론: 방골성 골육종의 오진의 가능성이 높으며 특히 대퇴골 이외에 발생한 경우 오진이 많았다. 대부분의 재발성 종양에 대한 재 절제는 가능하나 공격적 성향을 보이며 재발한 경우에는 주의가 필요할 것으로 생각된다.

Keywords

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