Abstract：
UNASSIGNED: Venous tumour thrombus (VTT) is a rare finding in osteosarcoma. Despite the high rate of VTT in osteosarcoma of the pelvis, there are very few descriptions of VTT associated with extrapelvic primary osteosarcoma. We therefore sought to describe the prevalence and presenting features of VTT in osteosarcoma of both the pelvis and the limbs.
UNASSIGNED: Records from a single institution were retrospectively reviewed for 308 patients with osteosarcoma of the pelvis or limb treated between January 2000 and December 2022. Primary lesions were located in an upper limb (n = 40), lower limb (n = 198), or pelvis (n = 70). Preoperative imaging and operative reports were reviewed to identify patients with thrombi in proximity to their primary lesion. Imaging and histopathology were used to determine presence of tumour within the thrombus.
UNASSIGNED: Tumours abutted the blood vessels in 131 patients (43%) and encased the vessels in 30 (10%). Any form of venous thrombus was identified in 31 patients (10%). Overall, 21 of these thrombi were determined to be involved with the tumour based on imaging (n = 9) or histopathology (n = 12). The rate of VTT was 25% for pelvic osteosarcoma and 1.7% for limb osteosarcoma. The most common imaging features associated with histopathologically proven VTT were enhancement with contrast (n = 12; 100%), venous enlargement (n = 10; 83%), vessel encasement (n = 8; 66%), and visible intraluminal osteoid matrix (n = 6; 50%). Disease-specific survival (DSS) for patients with VTT was 95% at 12 months (95% CI 0.87 to 1.00), 50% at three years (95% CI 0.31 to 0.80), and 31% at five years (95% CI 0.14 to 0.71). VTT was associated with worse DSS (hazard ratio 2.3 (95% CI 1.11 to 4.84).
UNASSIGNED: VTT is rare with osteosarcoma and occurs more commonly in the pelvis than the limbs. Imaging features suggestive of VTT include enhancement with contrast, venous dilation, and vessel encasement. VTT portends a worse prognosis for patients with osteosarcoma, with a similar survivability to metastatic disease.
UNASSIGNED: Records from a single institution were retrospectively reviewed for 308 patients with osteosarcoma of the pelvis or limb treated between January 2000 and December 2022. Primary lesions were located in an upper limb (n = 40), lower limb (n = 198), or pelvis (n = 70). Preoperative imaging and operative reports were reviewed to identify patients with thrombi in proximity to their primary lesion. Imaging and histopathology were used to determine presence of tumour within the thrombus.
UNASSIGNED: Tumours abutted the blood vessels in 131 patients (43%) and encased the vessels in 30 (10%). Any form of venous thrombus was identified in 31 patients (10%). Overall, 21 of these thrombi were determined to be involved with the tumour based on imaging (n = 9) or histopathology (n = 12). The rate of VTT was 25% for pelvic osteosarcoma and 1.7% for limb osteosarcoma. The most common imaging features associated with histopathologically proven VTT were enhancement with contrast (n = 12; 100%), venous enlargement (n = 10; 83%), vessel encasement (n = 8; 66%), and visible intraluminal osteoid matrix (n = 6; 50%). Disease-specific survival (DSS) for patients with VTT was 95% at 12 months (95% CI 0.87 to 1.00), 50% at three years (95% CI 0.31 to 0.80), and 31% at five years (95% CI 0.14 to 0.71). VTT was associated with worse DSS (hazard ratio 2.3 (95% CI 1.11 to 4.84).
UNASSIGNED: VTT is rare with osteosarcoma and occurs more commonly in the pelvis than the limbs. Imaging features suggestive of VTT include enhancement with contrast, venous dilation, and vessel encasement. VTT portends a worse prognosis for patients with osteosarcoma, with a similar survivability to metastatic disease.
摘要：
■静脉肿瘤血栓（VTT）是骨肉瘤的罕见发现。尽管VTT在骨盆骨肉瘤中的发生率很高，关于与肾盂外原发性骨肉瘤相关的VTT的描述很少。因此，我们试图描述VTT在骨盆和四肢骨肉瘤中的患病率和呈现特征。
■对2000年1月至2022年12月期间治疗的308例骨盆或肢体骨肉瘤患者的记录进行了回顾性审查。原发灶位于上肢（n=40），下肢（n=198），或骨盆（n=70）。审查了术前影像学和手术报告，以确定在原发病灶附近有血栓的患者。成像和组织病理学用于确定血栓内肿瘤的存在。
■肿瘤在131例患者（43％）中邻接血管，在30例（10％）中包裹血管。在31例患者（10％）中发现了任何形式的静脉血栓。总的来说,根据影像学（n=9）或组织病理学（n=12），确定其中21个血栓与肿瘤有关。骨盆骨肉瘤的VTT率为25％，四肢骨肉瘤为1.7％。与组织病理学证实的VTT相关的最常见的影像学特征是对比增强（n=12;100％），静脉扩大（n=10；83%），船舶外壳(n=8；66%)，可见管腔内类骨质基质（n=6；50％）。VTT患者在12个月时的疾病特异性生存率（DSS）为95％（95％CI0.87至1.00），三年时为50%（95%CI0.31至0.80），五年时为31%（95%CI0.14至0.71）。VTT与不良DSS相关（风险比2.3（95％CI1.11至4.84）。
■VTT在骨肉瘤中很少见，在骨盆比四肢更常见。提示VTT的影像学特征包括对比增强，静脉扩张,和船只外壳。VTT预示骨肉瘤患者预后较差，对转移性疾病有相似的生存能力。
■对2000年1月至2022年12月期间治疗的308例骨盆或肢体骨肉瘤患者的记录进行了回顾性审查。原发灶位于上肢（n=40），下肢（n=198），或骨盆（n=70）。审查了术前影像学和手术报告，以确定在原发病灶附近有血栓的患者。成像和组织病理学用于确定血栓内肿瘤的存在。
■肿瘤在131例患者（43％）中邻接血管，在30例（10％）中包裹血管。在31例患者（10％）中发现了任何形式的静脉血栓。总的来说,根据影像学（n=9）或组织病理学（n=12），确定其中21个血栓与肿瘤有关。骨盆骨肉瘤的VTT率为25％，四肢骨肉瘤为1.7％。与组织病理学证实的VTT相关的最常见的影像学特征是对比增强（n=12;100％），静脉扩大（n=10；83%），船舶外壳(n=8；66%)，可见管腔内类骨质基质（n=6；50％）。VTT患者在12个月时的疾病特异性生存率（DSS）为95％（95％CI0.87至1.00），三年时为50%（95%CI0.31至0.80），五年时为31%（95%CI0.14至0.71）。VTT与不良DSS相关（风险比2.3（95％CI1.11至4.84）。
■VTT在骨肉瘤中很少见，在骨盆比四肢更常见。提示VTT的影像学特征包括对比增强，静脉扩张,和船只外壳。VTT预示骨肉瘤患者预后较差，对转移性疾病有相似的生存能力。
