Anatomic origins of primary skeletal tumors effect metastatic and prognostic behaviors

Introduction: This study investigates the histology of nonmetastatic primary skeletal tumors related to their anatomic origin and its influence on 5-year survival outcomes. Methodology: Deidentified patient data were obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. Inclusion criteria included: (1) diagnosis of a primary bone cancer with anatomical location of origin, classified using ICD-O-3 anatomic site codes; (2) documented absence of metastasis to the brain, lung, liver, or bone; (3) cause-specific death and survival duration; and (4) available histology codes. Patients were stratified by primary tumor location and histologic sub-type. Kaplan-Meier survival curves were used to estimate survival, and group differences were assessed with pairwise log-rank tests. A p-value <0.05 was considered statistically significant. Results: The top five most common nonmetastatic skeletal tumors by histology are Chondrosarcoma, Osteosarcoma, Chondroma, Ewing Sarcoma, and Diffuse Large B-Cell Lymphoma (DLBCL). The tumor location distribution and 5-year survival for each histological subclass are outlined in Table 1. Conclusion: The differences in anatomic origin of primary bone tumors when controlled for histologic category influences patient mortality. There are distinct differences in overall survival compared among origin sites, signifying a location-based influence on disease severity and survival. The knowledge of anatomic origin differences of survival of various histologic categories of bone cancer can improve clinical decision making and create more accurate, locational based planning when looking at prognosis and disease progression.