Studies of the prognostic-associated risk factors for HOS have developed rapidly, and many kinds of prognostic factors have been reported, such as sex5, primary tumour site, tumour size6, tumour stage7, age at diagnosis8, pathologic fracture9, chemotherapy regimen and response to chemotherapy10, elevated serum lactate dehydrogenase (LDH) level, elevated alkaline phosphatase value (ALP) level11, presence of distant metastasis12, elevated serum C-reactive protein (CRP) level, and genetic factors13. This evidence concerns the gene CRP and Holt-Oram syndrome.