Recurrence Rate of Primary Bone and Soft Tissue Neoplasms of the Fingers
Jonathan Lans, MD; Kamilcan Oflazoglu, MD; Neal C Chen, MD; Santiago Lozano-Calderon, MD PhD
Massachusetts General Hospital, Boston, MA
Introduction: The influence of pathological finger fractures of primary bone tumors on the oncological outcome is unclear. The goal of this study was to identify if pathologic fractures of primary bone tumors of the fingers are associated with tumor recurrence
Methods: We retrospectively identified 110 patients with 112 primary bone tumors of the phalanges and metacarpals at two urban hospitals between 1992 and 2015. Tumors were classified on radiographs according to the modified Lodwick-Madewell classification and Enneking classification. We analyzed if patient demographics, tumor characteristics, or pathologic fracture were associated with recurrence. We performed a bivariate analysis to evaluate to evaluate these associations.
Results: The overall recurrence rate of phalangeal and metacarpal bone tumors was 11%. Malignant tumors had a higher recurrence rate compared to benign tumors, 29% versus 7.1% (p=0.031). Using the modified Lodwick-Madewell classification, the prevalence of malignant tumors was higher amongst the higher grades (p<0.001).
Conclusion: It appears that malignancy and higher histologic grade are more important predictors of recurrence than the presence of pathologic fracture. Larger studies are needed to determine the effect of pathologic fracture on recurrence.
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