Review Question - QID 3006

The distal femur is the most common location of osteosarcoma, followed by the proximal tibia, the proximal humerus, and then the spine and sacrum in decreasing frequency. The reference by Mankin et al reviewed 648 patients with centrally located osteosarcoma reviewed over a 30 year period at their institution. They found 222 cases involved the distal femur while 109 involved the proximal tibia. The proximal humerus ranked 3rd with 63 of the cases, and the spine/sacrum was farther down the list with 19 cases. The most profound independent variable that affected patient survival rate was use of chemotherapy. This was followed (in order) by the patient's age, MSTS stage of the tumor, percentage of cells killed after neoadjuvant therapy, tumor size, and anatomic site.