ArticleBMC cancer2026
Late-onset events in parosteal osteosarcoma: findings from a two-decade retrospective study.
Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough parosteal osteosarcoma (POS) is generally considered indolent with favorable short-term outcomes, its long-term biological behavior remains poorly understood. This study investigated late-onset events and prognostic factors for POS through an extended follow-up.
methodsWe retrospectively analyzed 84 patients with histologically confirmed POS treated between 2000 and 2020 at our institution. All patients were followed up for a minimum of 5 years. A subgroup analysis was performed for patients followed for more than 10 years to assess very late (> 10 years) local recurrence and distant metastases. Clinical, radiological, and pathological data were also analyzed. The secondary outcomes were survival rates and patterns of disease progression.
resultsAt a mean follow-up of 10.33 years (range, 5-21 years), local recurrence occurred in 22.6% (19/84) of patients, with 47.37% (9/19) of cases occurring after 10 years. Distant metastases developed in 13.1% (11/84) of patients, with 45.45% (5/11) manifesting after 10 years. Dedifferentiation occurred in 7.1% (6/84) of patients at a median of 8.7 years post-treatment. Multivariate analysis revealed that a tumor size > 8 cm (HR: 3.53, p = 0.018), medullary involvement (HR: 2.52, p = 0.049), and hemicortical resection (HR: 2.94, p = 0.041) were independent predictors of late-stage recurrence. The overall survival rates at 5, 10, and 15 years were 95.2%, 91.7%, and 88.1%, respectively.
conclusionsPOS has significant potential for late recurrence and metastasis beyond the conventional follow-up periods. These findings support the need for extended surveillance, particularly in patients with identified risk factors, and suggest that current follow-up protocols may require revision to account for late-onset events.
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