{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T18:13:03Z","timestamp":1760292783971,"version":"build-2065373602"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Primary rib osteosarcoma has not been investigated extensively, and clinical characteristics and optimal therapeutic strategies have not been defined. The authors used the database of the Cooperative Osteosarcoma Study Group (COSS) to analyze this tumor\u2010site in depth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The COSS database was searched for treatment\u2010naive, high\u2010grade osteosarcomas of the rib. Affected patients were analyzed for demographic and tumor\u2010related factors, treatments, and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 44 patients (23 males, 21 females; median age, 23 years [range, 6\u201359]) were identified. Primary metastases were detected in six of 44 (14%) patients. Surgery was performed in 40 of 44 (91%) patients and rendered 35 of 44 (80%) patients macroscopically disease\u2010free. Chemotherapy was known to have been administered in 43 of 44 (98%) patients and radiotherapy in seven of 42 (17%) (no data for two patients). A good response to chemotherapy was only noted in five (33%) of those 15 evaluable patients who had received any preoperative chemotherapy. After a median follow\u2010up of 2.49 (0.22\u201340.35) years for all patients and 6.61 (0.25\u201340.35) years for 26 survivors (21 of these in first complete remission), 5\u2010year actuarial overall and event\u2010free survival were 53.0% (8.5%) and 42.2% (8.1%), respectively. Incomplete tumor surgery was the most notable negative prognostic factor. Osteoblastic histology and a poor response to chemotherapy may have contributed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This large series provides evidence that patients with costal primaries are older than the average osteosarcoma patient, but appear to share the similar tumor biology and\u2014if treated according to standard protocols\u2014prognostic factors with tumors of other sites. Early, preoperative diagnosis and permanent, definitive local control remain major challenges and should contribute to improved outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34744","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T07:40:25Z","timestamp":1679038825000},"page":"1895-1903","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Primary osteosarcoma of the ribs: A report from the Cooperative Osteosarcoma Study Group"],"prefix":"10.1002","volume":"129","author":[{"given":"Nicole","family":"Bodmer","sequence":"first","affiliation":[{"name":"Onkologie Universit\u00e4tskinderspital Z\u00fcrich  Zurique Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanie","family":"Hecker\u2010Nolting","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart\u2010Olgahospital Stuttgart Cancer Center Zentrum f\u00fcr Kinder\u2010, Jugend\u2010, und Frauenmedizin P\u00e4diatrie 5 (Onkologie, H\u00e4matologie, Immunologie)  Stuttgart Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Godehard","family":"Friedel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Thorax\u2010, Herz\u2010, und Gef\u00e4\u00dfchirurgie Sektion Thoraxchirurgie Universit\u00e4tsklinikum T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Blattmann","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart\u2010Olgahospital Stuttgart Cancer Center Zentrum f\u00fcr Kinder\u2010, Jugend\u2010, und Frauenmedizin P\u00e4diatrie 5 (Onkologie, H\u00e4matologie, Immunologie)  Stuttgart Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo","family":"Kager","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Kinder und Jugendheilkunde Medizinische Universit\u00e4t Wien St. Anna Kinderspital and St. Anna Children's Cancer Research Institute  Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torsten","family":"Kessler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin A: H\u00e4matologie, H\u00e4mostaseologie, Onkologie und Pneumologie Universit\u00e4tsklinikum M\u00fcnster  M\u00fcnster Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Kevric","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart\u2010Olgahospital Stuttgart Cancer Center Zentrum f\u00fcr Kinder\u2010, Jugend\u2010, und Frauenmedizin P\u00e4diatrie 5 (Onkologie, H\u00e4matologie, Immunologie)  Stuttgart Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"K\u00fchne","sequence":"additional","affiliation":[{"name":"Abteilung H\u00e4matologie\/Onkologie Universit\u00e4tskinderspital Beider Basel  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Mettmann","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart\u2010Olgahospital Stuttgart Cancer Center Zentrum f\u00fcr Kinder\u2010, Jugend\u2010, und Frauenmedizin P\u00e4diatrie 5 (Onkologie, H\u00e4matologie, Immunologie)  Stuttgart Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"M\u00fcller\u2010Abt","sequence":"additional","affiliation":[{"name":"Radiologisches Institut Zentrum f\u00fcr Kinder\u2010, Jugend\u2010, und Frauenmedizin Stuttgart Cancer Center Klinikum Stuttgart\u2010Olgahospital  Stuttgart Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Sorg","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart\u2010Olgahospital Stuttgart Cancer Center Zentrum f\u00fcr Kinder\u2010, Jugend\u2010, und Frauenmedizin P\u00e4diatrie 5 (Onkologie, H\u00e4matologie, Immunologie)  Stuttgart Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Theobald","sequence":"additional","affiliation":[{"name":"III. 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