Abstract
Primary bone neoplasms are rare, contributing only 0.2% of the global burden of all human malignancies. Osteosarcoma (OS) and chondrosarcoma (CS) are the most common malignancies of bone. The giant cell tumor of bone (GCTb) is a benign tumor with behavior characterized by osteolytic bone destruction. The OS, CS and GCTb affect both sexes, all races and generally have incidence peaks regarding the age of the patient which vary according to the tumor type. We analyzed the incidences of OS, CS and GCTb and their relations with gender and age in patients treated in the National Rehabilitation Institute (INR, for its acronym in Spanish) over a period of nine years. In the study period, clinic pathological data for 384 patients were obtained with clinical, radiological and histopathological diagnosis for OS, GCTb and CS. Data analysis was performed using the chi-square and Fisher's exact tests. From 2006 to 2014 were recorded 384 cases of bone malignancies in the database of INR. The GCTb had the highest incidence (53.1%), followed by OS (31.3%) and finally the CS (15.6%). The overall average age was 33.6±15.8 years and the overall frequency of gender had a ratio of 1/1.03 male/female. The states with the highest incidence were Distrito Federal and Estado de Mexico with 29.2% and 25.3% respectively. Malignant neoplasms of bone assessed in the course of nine years show three significant increases in 2008, 2011 and 2014 (p=0.14). We found association between sex and tumor type (p=0.03), GCTb and CS predominated in females (54.9% and 56.6% respectively), while for the OS males were most affected (59.1%). Age was different in relation with tumor type (p=0.0001), average age was 24.3±11.2 years for OS, 34.5±13 years for GCTb and 49.2±18.5 years for CS. Furthermore, associations of tumor type with topographic location of the primary tumor (P=0.0001) were found. In this study we can see that incidence of musculoskeletal tumor in our population is continuously increasing and in nine years an approximately 200% increase of musculoskeletal tumor cases was observed.
Highlights
The Osteosarcoma is highly malignant and its origin from mesenchyme is characterized by the formation of immature or osteoid bone, it has reported an incidence of 35% between all primary bone malignancies
In this study from 2006 to 2014 was observed that, with respect to OS, giant cell tumor of bone (GCTb) and CS, 42.6 cases were filed per year; this represents an overall increase of 73.17% compared to that observed in the period from 2000 to 2005 in Mexico, where 24.6 cases reported per year (Baena-Ocampo et al, 2009)
Regarding the OS, a relative incidence of 12.3 cases per year were identified in GCTb was 22.6 cases per year and the CS was 6.6 cases per year; compared with those reported by Baena-Ocampo, our results suggest an increase in the relative incidence of OS 6.4%, GCTb 130.61% and CS 186.95%. (Baena-Ocampo et al, 2009)
Summary
The Osteosarcoma is highly malignant and its origin from mesenchyme is characterized by the formation of immature or osteoid bone, it has reported an incidence of 35% between all primary bone malignancies. Cartilage tissue is the origin of CS and ranks second in incidence of all primary malignant bone tumors, with reporting about 25% incidence (Geest et al, 2002) regarding age, CS it is more common in adults between 40-80 years old, and is slightly more common in men. In the case of GCTb, it has been reported incidence varies from 5% to 20% of tumors of primary bone in adults (Turcotte, 2006), GCTb is characterized by an intramedullary bone tumor composed of mononuclear cells and multinucleated giant cells to cause osteoclasts the osteolytic bone destruction, their behavior is aggressive, mainly affects the metaphyseal region of long bones, especially in the knee joint. The OS, CS and GCTb affect both sexes, all races and generally have incidence peaks regarding the age of the patient which vary according to the tumor type. Conclusions: In this study we can see that incidence of musculoskeletal tumor in our population is continuously increasing and in nine years an approximately 200% increase of musculoskeletal tumor cases was observed
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