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Volume 2018, Article ID 1632978, 11 pages
Research Article

High-Grade Osteosarcoma of the Foot: Presentation, Treatment, Prognostic Factors, and Outcome of 23 Cooperative Osteosarcoma Study Group COSS Patients

1Center for Pediatric, Adolescent and Women's Medicine, Olgahospital, Department of Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart, Stuttgart, Germany
2St. Anna Children’s Hospital, Department of Paediatrics, Medical University of Vienna and Children’s Cancer Research Institute (CCRI), Vienna, Austria
3Department of Interdisciplinary Oncology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
4Bone Tumour Reference Centre (BTRC), Institute of Pathology, University Hospital of Basel and University of Basel, Basel, Switzerland
52nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
6Department of Pathology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
7Department of Hematology and Oncology, Klinikum rechts der Isar Technische Universität München, Munich, Germany
8Department of Internal Medicine III, University of Ulm, Ulm, Germany
9Center for Pediatric, Adolescent and Women’s Medicine, Olgahospital, Department of Pediatric Radiology, Klinikum Stuttgart, Stuttgart, Germany
10Department of Orthopaedics, Medical University of Vienna, Vienna, Austria
11Center for Pediatric, Adolescent and Women’s Medicine, Olgahospital, Department of Pediatrics, Division of Pediatric Orthopedics, Klinikum Stuttgart, Stuttgart, Germany
12Department of Pediatric Hematology and Oncology, University Children’s Hospital Muenster, Muenster, Germany

Correspondence should be addressed to Anne J. Schuster; ed.tragttuts-mukinilk@retsuhcs.enna

Received 21 November 2017; Revised 15 February 2018; Accepted 18 March 2018; Published 2 May 2018

Academic Editor: Valerae O. Lewis

Copyright © 2018 Anne J. Schuster et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Osteosarcoma of the foot is a very rare presentation of a rare tumor entity. In a retrospective analysis, we investigated tumor- and treatment-related variables and outcome of patients registered in the Cooperative Osteosarcoma Study Group (COSS) database between January 1980 and April 2016 who suffered from primary high-grade osteosarcoma of the foot. Among the 23 eligible patients, median age was 32 years (range: 6–58 years), 10 were female, and 13 were male. The tarsus was the most commonly affected site (). Three patients had primary metastases. All patients were operated: 5 underwent primary surgery and 18 received surgery following preoperative chemotherapy. In 21 of the 23 patients, complete surgical remission was achieved. In 4 of 17 patients, a poor response to neoadjuvant chemotherapy was observed in the resected primary tumors. Median follow-up was 4.2 years (range: 0.4–18.5). At the last follow-up, 15 of the 23 patients were alive and 8 had died. Five-year overall and event-free survival estimates were 64% (standard error (SE) 12%) and 54% (SE 13%), which is similar to that observed for osteosarcoma in general. Event-free and overall survival correlated with primary metastatic status and completeness of surgery. Our findings show that high-grade osteosarcoma in the foot has a similar outcome as osteosarcoma of other sites.