Clinicopathological correlations and prognostic insights in osteosarcoma: a retrospective analysis
Authors:   Department of Orthopedics and Traumatology, University of Medicine and Pharmacy of Craiova, Romania, Niculescu Ştefan Adrian , Grecu Alexandru Florian ,   Department of Orthopedics and Traumatology, University of Medicine and Pharmacy of Craiova, Romania, Stepan Alex Emilian ,   Department of Pathology, University of Medicine and Pharmacy of Craiova, Romania, Muşat Mădălina Iuliana ,   Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, Romania, Moroşanu Aritina-Elvira ,   Department of Pediatrics, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania, Bălşeanu Tudor Adrian ,   Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, Romania; Department of Physiology, Physiopathology, and Neuroscience, University of Medicine and Pharmacy of Craiova, Romania, Hadjiargyrou Michael ,   Department of Biological and Chemical Sciences, New York Institute of Technology, Old Westbury, New York, USA, Grecu Dan Cristian ,   Department of Orthopedics and Traumatology, University of Medicine and Pharmacy of Craiova, Romania
Published: February 2025

Osteosarcoma (OS) is the most prevalent primary bone malignancy, predominantly affecting adolescents and young adults, and presents significant clinical challenges due to its aggressive nature and high potential for metastasis. This retrospective study analyzed 34 cases of primary OS, aged 10 to 65 years, to identify clinicopathological correlations that could inform future research and treatment strategies. The findings aim to guide larger cohort studies, essential for validating these correlations and developing tailored approaches that enhance patient outcomes. The analysis focused on demographic factors, sex, tumor grade, stage, size, and histological subtype, utilizing criteria established by the American Joint Committee on Cancer (AJCC) and the World Health Organization (WHO). The results revealed a predominance of the disease in males under 25 years of age, with the femur being the most common site of occurrence. Conventional osteoblastic OS emerged as the most frequent subtype, accounting for 50% of the cases, predominantly presenting as high-grade (G3) tumors. Over 70% of the tumors were T1 in extension (≤8 cm) and classified as stage IIA, indicating a locally advanced disease state. Correlations were observed between histological type, grade, and stage, underscoring the importance of detailed histopathological (HP) assessments in determining prognosis and guiding treatment. The findings highlight correlations between histological subtype, grade, and stage, reaffirming the critical role of detailed HP assessments in prognosis and treatment planning. While the limited sample size necessitates cautious interpretation, this study provides valuable regional and age-specific insights that could inform clinical decision-making. Future research should prioritize multi-center studies and delve into the genetic and molecular underpinnings of OS subtypes to enhance understanding and develop targeted therapies.