To evaluate the association between post-chemotherapy physeal breach and pulmonary metastasis in pediatric osteosarcoma, highlighting its potential clinical significance.
Key Findings:
Pulmonary metastases were present in 22% of patients at diagnosis and increased to 50% by last follow-up (16/32).
Physeal breach was the only independent predictor of metastasis with an odds ratio of 59.89 (95% CI: 3.34–1073.95).
In the xenograft model, all physeal-breach mice developed pulmonary metastases, while none in the non-breach group did.
Increased angiogenic activity was observed in breach-associated tumours via VEGF IHC.
Interpretation:
Physeal breach serves as a significant indicator of aggressive disease and high metastatic potential in pediatric osteosarcoma, suggesting its utility as a practical biomarker for risk stratification and clinical decision-making.
Limitations:
The study is limited by its retrospective design and small sample size, which may introduce biases.
Findings may not be generalizable beyond the single-centre cohort.
Conclusion:
Physeal breach is a critical factor in predicting pulmonary metastasis in pediatric osteosarcoma, potentially guiding treatment strategies and risk assessment in clinical practice.
