The Proliferation of Osteosarcoma: The Impact of Phenol and Ethanol on Ki-67 Expressions

Document Type : Short Communications

Authors

1 Orthopedics & Traumatology Department, Faculty of Medicine, Sebelas Maret University, Moewardi General Hospital, Surakarta, Indonesia.

2 Resident of Orthopedics & Traumatology Specialist Programe, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia.

3 Anatomical Pathology Department, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia.

Abstract

Background: Osteosarcoma is an aggressive primary bone malignancy characterized by a high rate of cellular proliferation, necessitating effective local control strategies. Ethanol and phenol have been utilized as adjuvant agents to inhibit tumor proliferation. However, comparative studies evaluating their efficacy in reducing osteosarcoma proliferation remain limited. This study aims to compare the effects of ethanol and phenol on reducing the proliferation of osteosarcoma, particularly in delineating tumor resection margins microscopically. Methods: This experimental study was conducted at Dr. Moewardi General Hospital and the Anatomical Pathology Laboratory of the Faculty of Medicine, Sebelas Maret University, Surakarta from August to December 2024. Samples were obtained using purposive sampling. Osteosarcoma specimens were analyzed using immunohistochemistry to measure Ki-67 expression and divided into three treatment groups: ethanol, phenol, and NaCl (control). Statistical analyses included the Kruskal-Wallis test and Dunn’s post hoc test to evaluate differences in Ki-67 expression among groups. Results: A total of 22 osteosarcoma specimens were analyzed. The results demonstrated that both ethanol and phenol were effective as local control agents in reducing osteosarcoma proliferation, as measured by Ki-67 expression. Ethanol exhibited significantly greater efficacy compared to phenol and NaCl (p<0.05). The median Ki-67 expression levels were 5 (1–20) in the ethanol group, 10 (2–30) in the phenol group, and 20 (10–60) in the NaCl group. Conclusion: Both ethanol and phenol are effective as local control agents. However, ethanol demonstrates superior efficacy in reducing Ki-67 expression, establishing its potential as a more effective adjuvant in the management of osteosarcoma.

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Articles in Press, Accepted Manuscript
Available Online from 13 September 2025
  • Receive Date: 22 April 2025
  • Revise Date: 08 June 2025
  • Accept Date: 29 August 2025