What is the clinical evidence from this study?

Study design: Observational. Population: Primary pulmonary osteosarcoma (n=25). Intervention: Surgical resection vs. No surgery. Primary outcome: Overall survival (HR 0.02, 95% CI 0.00-0.18, p=<0.001).

What question did this study set out to answer?

To report a new case of primary pulmonary osteosarcoma and analyze clinical profiles and prognostic factors from literature.

July 24, 2026World Journal of Surgical OncologyOpen Access

Primary pulmonary osteosarcoma: a case report, literature review and pooled analysis

Q: What are the key findings of this study?

Surgical resection significantly improved overall survival (HR 0.02) compared to no surgery in patients with primary pulmonary osteosarcoma.

Q: What question did this study set out to answer?

To report a new case of primary pulmonary osteosarcoma and analyze clinical profiles and prognostic factors from literature.

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Key result

Surgical resection is linked to ~98% lower mortality vs no surgery in primary pulmonary osteosarcoma.

HR 0.02
95% CI 0.00-0.18
P<0.001
n=25

Why the study?

Owing to the rarity of primary pulmonary osteosarcoma, its clinical features and prognostic factors remain poorly defined.

Does surgical resection improve overall survival in patients with primary pulmonary osteosarcoma?

Key Points

To report a new case of primary pulmonary osteosarcoma and analyze clinical profiles and prognostic factors from literature.
Comprehensive literature review conducted using PubMed, Medline, and Cochrane Library.
Pooled analysis included 38 cases with 25 having sufficient clinical and survival data.
Overall survival assessed using Kaplan-Meier method and Cox proportional hazards models.
Older age (>64 years) associated with poorer overall survival (OS), P<0.001.
Surgical resection significantly improved OS for all age groups, P=0.003 for ≤64 years, P<0.001 for >64 years.
Adjuvant chemotherapy showed a trend towards improved OS (P=0.053) but was not statistically significant.

Study Design

Type

Observational (n=25)

Structured PICO

Does surgical resection improve overall survival in patients with primary pulmonary osteosarcoma?

Population

25 patients with primary pulmonary osteosarcoma, median age 64 years, included in a pooled retrospective analysis to evaluate prognostic factors and survival outcomes.

Exposure

Surgical resection (with or without adjuvant chemotherapy)

Comparator

No surgical resection

Outcome

Overall survival (OS)hard clinical

Main Result

Hazard Ratio: 0.02 (95% CI 0–0.18)

p-value: p=<0.001

Surgical resection improves overall survival in patients with primary pulmonary osteosarcoma regardless of age or tumor size.

Limitations

The reported case patient declined surgical resection, precluding evaluation of complete tumor excision.
Differences in diagnostic timing, imaging techniques, treatment approaches, and follow-up duration among included studies.
No centralized pathology or radiological review was performed.
Potential selection bias between surgical and nonsurgical groups, as patients undergoing surgery may have had more favorable baseline characteristics.
Very small sample size (n = 25) leading to statistical instability and potential risk of model overfitting in multivariable Cox regression.
Small sample size
Need for larger multi-institutional studies

Discussion

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Implication

Adjuvant chemotherapy shows a nonsignificant OS trend after PPOS resection; hypothesis-generating and requires prospective trials before practice change.

Cite This Study

Zhou et al. (2026) conducted an observational in Primary pulmonary osteosarcoma (n=25). Surgical resection vs. No surgery was evaluated on Overall survival (HR 0.02, 95% CI 0.00-0.18, p=<0.001). Surgical resection significantly improved overall survival (HR 0.02) compared to no surgery in patients with primary pulmonary osteosarcoma.

synapsesocial.com/papers/6a6301d3395161722cd16531 https://doi.org/10.1186/s12957-026-04512-2

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Implication

Adjuvant chemotherapy shows a nonsignificant OS trend after PPOS resection; hypothesis-generating and requires prospective trials before practice change.

Primary pulmonary osteosarcoma: a case report, literature review and pooled analysis

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Primary pulmonary osteosarcoma: a case report, literature review and pooled analysis

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider