Schlegel M, et al. - The prognostic impact of pathological fractures (PF) in patients with osteosarcoma (OS) or Ewing tumor (ET) was determined, with a focus on 5-year survival, occurrence of metastases, and local recurrence. Patients with vs without PF demonstrated survival rates of 64% vs 83%, respectively. A decrease in survival rate, from 83 to 59% and increase in local recurrence rate (from 13 to 30%) was noted in patients with OS. Age and PF were shown to be related to inferior survival in multivariate analysis. Overall, the occurrence of PF negatively influenced survival and implicated an increased risk of local recurrence. No prognostic impact of PF was seen in children and in patients with ET.