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Effect of adjuvant chemotherapy on localized dedifferentiated low-grade osteosarcoma: a systematic review

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MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

Abstract

Purpose

Dedifferentiated low-grade osteosarcomas, which are considered high grade malignancies, can arise from the dedifferentiation of parosteal and low-grade osteosarcomas. Usually, localized dedifferentiated low-grade osteosarcomas are treated by wide resection, and the efficacy of adjuvant chemotherapy is controversial. We conducted a systematic review of studies that investigated the rates of mortality and significant events, such as recurrence and metastases, in localized dedifferentiated low-grade osteosarcoma patients who received wide resection only and in those who received wide resection and (neo-)adjuvant chemotherapy.

Methods

We identified 712 studies through systematic searches of Embase, PubMed, and the Cochrane Central Register of Controlled Trials databases. Of those studies, seven were included in this review and none were randomized controlled trials. In the seven studies, 114 localized dedifferentiated low-grade osteosarcoma patients were examined.

Results

Mortality rates of the resection plus chemotherapy (R + C) and the resection only (Ronly) groups were 20.3% and 11.4%, respectively [overall pooled odds ratio, 1.59 (P = 0.662); heterogeneity I2, 0%]. The local recurrence or distant metastasis rate in the R + C group was 36.7% and that in the Ronly group was 28.6% [overall pooled odds ratio, 1.37 (P = 0.484); heterogeneity I2 was 0%].

Conclusions

Results show a limited efficacy of adjuvant chemotherapy for localized dedifferentiated low-grade osteosarcoma. However, because this was a systematic review of retrospective studies that examined a small number of patients, future randomized controlled trials are needed.

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Availability of data and material

The data supporting this systematic review are from previously reported studies and datasets, which have been cited. The processed data are available in Tables 1, 2, and 3.

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Acknowledgements

The authors thank Mr. Takaaki Suzuki (Library, Nara Medical University, Japan) for the literature searches.

Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Nara Medical University, 840, Shijo-Cho, Kashihara-City, Nara, 634-8521, Japan

    S. Tsukamoto, T. Masunaga, K. Honoki, H. Fujii & Y. Tanaka

  2. Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136, Bologna, Italy

    A. Righi

  3. First Department of Orthopedics, School of Medicine, National and Kapodistrian University of Athens, 41 Ventouri Street, 15562, Holargos, Athens, Greece

    A. F. Mavrogenis

  4. Department of Rehabilitation Medicine, Nara Medical University, 840, Shijo-Cho, Kashihara-City, Nara, 634-8521, Japan

    A. Kido

  5. Department of Rehabilitation Medicine, Wakayama Professional University of Rehabilitation, 3-1, Minamoto-Cho, Wakayama-City, 640-8222, Japan

    Y. Tanaka

  6. Department of Orthopedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy

    C. Errani

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  1. S. Tsukamoto
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Contributions

Research, data analysis, and writing (S.T., A.F.M, T.M., and A.K).; writing (A.R.); study integration and manuscript revision [K.H., H.F., Y.T. (Yuu Tanaka), Y.T. (Yasuhito Tanaka), and C.E]. All authors have read and agreed to the published version of the manuscript.

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Correspondence to S. Tsukamoto.

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Tsukamoto, S., Righi, A., Mavrogenis, A.F. et al. Effect of adjuvant chemotherapy on localized dedifferentiated low-grade osteosarcoma: a systematic review. Musculoskelet Surg (2024). https://doi.org/10.1007/s12306-024-00821-5

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