Abstract
Osteosarcoma is the most common bone tumour of the paediatric age. Long time survival can be reached in 70% of patients when metastatic disease is absent at presentation. But in spite of aggressive chemotherapy regimens, about 30% of patients die of the disease.
This retrospective study was carried on 120 patients with primary non-metastatic osteosarcoma of the extremities, attending at Cairo University Hospitals (Faculty of Medicine and National Cancer Institute) between January 1993 and June 2006. The patients’ functional outcome was evaluated according to the Musculoskeletal Tumor Society Functional Rating System.
All patients have undergone surgical resection of the tumour and limb salvage. They have received different chemotherapy regimens depending on the time of entry to the study. Four patients were treated according the Osteosarcoma Group Study I (OSGI): six courses of adjuvant cisplatin and doxorubicin. Twenty patients received OSGII: 2 neoadjuvant and 4 adjuvant courses of cisplatin and doxorubicin. Twenty-nine patients received OSGIII: high-dose methotrexate, ifosfamide, doxorubicin, and cisplatin. Sixty-seven patients received OSGIV: high dose cisplatin, ifosfamide, doxorubicin and a cardioprotective agent. Patients with limb salvage surgery were divided into 3 groups: mobile joints (33 patients), fused joints (75 patients) and rotation plasty (12 patients).
The 5-year event free survival and overall survival for the 120 patients were 70.9 % and 71.3% respectively at median follow-up of 54.5 months and a range of 5–153 months. Functional outcome for available patients according to MST rating system was < 70% in 34 patients and > 70 % in 86 patients. There was not a statistically significant difference between survival and different prognostic factors (age, sex, tumour site, tumour size, tumour necrosis, pathology and time of chemotherapy). Only serum LDH and alkaline phosphatase were statistically significant when correlated with survival.
The results of this study seem to be in accordance with other studies in the literature.
Correspondence should be addressed to Professor Stefan Bielack, Olgahospital, Klinikum Stuttgart, Bismarkstrasse 8, D-70176 Stuttgart, Germany. Email: s.bielack@klinikum_stuttgart.de
