{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:11:41Z","timestamp":1790727101137,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,9,18]],"date-time":"2014-09-18T00:00:00Z","timestamp":1410998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["30973444; 81172547"],"award-info":[{"award-number":["30973444; 81172547"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Consensus has not been reached regarding the ability of pathologic fracture to predict local recurrence and survival in osteosarcoma. We aim to review the available evidence to examine the association between pathologic fracture and osteosarcoma prognosis. A comprehensive literature search for relevant studies published until March 2014 was performed using PubMed, Cochrane and Web of Science. The studies investigating pathologic fracture of osteosarcoma patients were systematically analyzed. The overall relative risk (RR) was estimated using a fixed\u2010effect model or random\u2010effect model according to heterogeneity between the trials. We included nine cohort studies involving 2,187 patients (311 with pathologic fracture and 1,876 without fracture) for the analysis of survival rate and local recurrence. Studies were assessed for quality using the Newcastle\u2013Ottawa Assessment Scale. In the fixed\u2010effects model, the meta\u2010analysis showed that pathologic fracture in osteosarcoma patients predicted poor 3\u2010year overall survival (OS) (RR\u2009=\u20091.86, 95% CI: 1.37\u20132.53,\n                      <jats:italic>p\u2009<\/jats:italic>\n                      &lt;\u20090.001) and 5\u2010year OS (RR\u2009=\u20091.34, 95% CI: 1.06\u20131.70,\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.016). Similarly, pathologic fracture was significantly correlated with worse 3\u2010year event free survival (EFS) (RR\u2009=\u20091.52, 95% CI: 1.21\u20131.92,\n                      <jats:italic>p\u2009<\/jats:italic>\n                      &lt;\u20090.001) and 5\u2010year EFS (RR\u2009=\u20091.24, 95% CI: 1.03\u20131.49,\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.021), whereas no significant association was noted with local recurrence (RR\u2009=\u20091.30, 95% CI: 0.84\u20132.02,\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.233). The meta\u2010analysis confirmed that pathologic fracture in osteosarcoma was a prognostic marker for both OS and EFS but not for local recurrence. \u00a9 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:131\u2013139, 2015.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jor.22734","type":"journal-article","created":{"date-parts":[[2014,9,18]],"date-time":"2014-09-18T03:11:12Z","timestamp":1411009872000},"page":"131-139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Prognostic value of pathologic fracture in patients with high grade localized osteosarcoma: A systemic review and meta\u2010analysis of cohort studies"],"prefix":"10.1002","volume":"33","author":[{"given":"Lingling","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Orthopedics the Second Affiliated Hospital School of Medicine Zhejiang University No. 88, Jiefang Road Hangzhou 310009 P.R. 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