Abstract：
OBJECTIVE: 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.
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.
摘要：
目的：去分化低级别骨肉瘤，被认为是高度恶性肿瘤，可能起因于骨旁和低度骨肉瘤的去分化。通常,局部去分化低度骨肉瘤通过广泛切除治疗，辅助化疗的疗效存在争议。我们对调查死亡率和重大事件的研究进行了系统回顾，如复发和转移，仅接受广泛切除的局部去分化低度骨肉瘤患者以及接受广泛切除和(新)辅助化疗的患者.
方法：我们通过对Embase的系统搜索确定了712项研究，PubMed,和Cochrane中央对照试验注册数据库。在这些研究中,7项纳入本综述,无一项为随机对照试验.在七项研究中，检查了114例局部去分化低度骨肉瘤患者。
结果：切除加化疗（RC）和仅切除（Ronly）组的死亡率分别为20.3％和11.4％，分别为[总合并赔率比，1.59（P=0.662）；异质性I2，0%]。R+C组的局部复发或远处转移率为36.7%，而Ronly组为28.6%[总体合并比值比，1.37(P=0.484)；异质性I2为0%]。
结论：结果显示局部去分化低度骨肉瘤的辅助化疗疗效有限。然而,因为这是对少数患者的回顾性研究的系统回顾，需要未来的随机对照试验.
方法：我们通过对Embase的系统搜索确定了712项研究，PubMed,和Cochrane中央对照试验注册数据库。在这些研究中,7项纳入本综述,无一项为随机对照试验.在七项研究中，检查了114例局部去分化低度骨肉瘤患者。
结果：切除加化疗（RC）和仅切除（Ronly）组的死亡率分别为20.3％和11.4％，分别为[总合并赔率比，1.59（P=0.662）；异质性I2，0%]。R+C组的局部复发或远处转移率为36.7%，而Ronly组为28.6%[总体合并比值比，1.37(P=0.484)；异质性I2为0%]。
结论：结果显示局部去分化低度骨肉瘤的辅助化疗疗效有限。然而,因为这是对少数患者的回顾性研究的系统回顾，需要未来的随机对照试验.
