BACKGROUND: High-grade foci (grade 3 according to Broder's grading system) are sometimes detected in low-grade (grade 1 and 2) @entity421 . The aim of this study was to retrospectively evaluate the clinical outcome in @entity1 upgraded to high grade (grade 3) after a first diagnosis of @entity258 , following the detection of high-grade areas (grade 3) in the resected specimen. METHODS: Of the 132 @entity1 with a diagnosis of @entity258 at surgical biopsy at our Institute, 33 @entity1 were considered eligible for the study. RESULTS: Median age was 37 (range 13-58  years). Location was in an extremity in 29 @entity1 (88  %). Post-operative chemotherapy was given in 22 (67  %) @entity1 . Follow-up data were available for all @entity1 , with a median observation time of 115  months (range 4-322  months). After histological revision, areas of high-grade (grade 3) @entity421 accounting for less than 50  % of the @entity5 were found in 20 (61  %) @entity1 , whereas the majority of the @entity5 was composed of a high-grade (grade 3) component in 13 (39  %) @entity1 . In the 20 cases of @entity258 with high-grade foci (grade 3) in less than 50  % of the @entity5 , 9 @entity1 did not receive adjuvant chemotherapy; only one of them died, of unrelated causes. In the adjuvant chemotherapy group (11 out of 20 @entity1 ), one @entity1 developed multiple lung metastases and died of disease 39  months after the first diagnosis. In the other 13 cases of @entity258 with high-grade foci (grade 3) in more than 50  % of the @entity5 , 12 @entity1 received adjuvant chemotherapy: 2 had recurrence, 4 developed multiple lung metastases and 3 died of disease. The only @entity1 who did not receive chemotherapy is alive without disease 232  months after complete surgical remission. CONCLUSION: Our data indicate that @entity1 with a diagnosis of @entity258 where the high-grade (grade 3) component is lower than 50  % of the resected specimen, may not require chemotherapy, achieving high survival rates by means of complete surgical resection only.

High-grade focal areas in XXXX : high-grade or still @entity258 ?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity421 :: ('MESH:D012516', 'Disease') :: ['central osteosarcoma', 'osteosarcoma'] @entity258 :: ('MESH:D009800', 'Disease') :: ['low-grade central osteosarcoma', 'low-grade osteosarcoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor']
@entity258 :: (MESH:D009800,Disease) :: ['low-grade central osteosarcoma']
