Introduction: The prognostic role of pathologic fracture in osteosarcoma has not been settled down, as previous researches have reached contradictory results. This study is prepared to clarify whether pathologic fracture predicts a poor prognosis of patients with osteosarcoma. Materials and Methods: After completely retrieved databases including China National Knowledge Infrastructure (CNKI), PubMed, Highwire, EMBASE and Science Direct, all eligible articles were included based on inclusion/exclusion criteria. And we performed a meta-analysis to calculate the pooled prognostic role of pathologic fracture in osteosarcoma. Results: Finally, a total of 8 articles met the inclusion/exclusion criteria, involving 1,677 subjects. We found that the pooled hazard ratios (HRs) with 95% confidential interval (CI) of pathologic fracture in osteosarcoma for overall survival (OS) and disease-free survival (DFS) are 2.13 (1.43, 3.15) and 1.58 (1.11, 2.24), respectively. Conclusion: This meta-analysis demonstrated that presentation with a pathologic fracture in osteosarcoma was correlated with a poor prognosis. And pathologic fracture might be a poor predictor of survival in osteosarcoma
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