Abstract
<strong>Background:</strong> Predictive factors for long-term outcomes in osteosarcoma patients are still controversial. There is no literature available regarding these factors in a patient population in a developing country.<br /><strong>Aim and setting:</strong> To determine the outcome of treatment of osteosarcoma patients treated at Groote Schuur Hospital from 1990 to 2012 in terms of locoregional control (LRC), disease-free survival (DFS) and overall survival (OS) and to determine the value of suggested predictive factors in this population.<br /><strong>Patients and methods:</strong> Retrospective review of all patients diagnosed with and treated for osteosarcoma at Groote Schuur Hospital between 1990 and 2012, considering OS, DFS and LRC. This review assesses the significance of suggested predictive factors from other studies, namely, HIV status, age at diagnosis, site of primary disease, type of chemotherapy used, response to chemotherapy and type of surgery in terms of OS, DFS and LRC.<br /><strong>Results:</strong> Forty-three patients with histologically confirmed osteosarcoma were treated at Groote Schuur Hospital between 1990 and 2012. Median 5 year OS was 57.8%. On univariate analysis, the site of disease was the only statistically significant predictive factor for prognosis.<br /><strong>Conclusion:</strong> On univariate analysis, patients with axial disease have a worse predicted prognosis than those with primary disease in their extremities. The clinical behaviour and long-term outcome after treatment of these patients with osteosarcoma are similar to that seen internationally.
Highlights
Osteosarcomas are uncommon tumours, but they are the commonest primary bone tumour diagnosed, with a bimodal age distribution
The majority of osteosarcomas are found in the long bones of the extremities, but they can be found in the axial skeleton and extraskeletally.[2]
A total of 42 patients were included in the initial analysis, but 5 were excluded because of defaulting any treatment other than their initial visit, leaving the remaining 37 patients as the patient population included in this case series
Summary
Osteosarcomas are uncommon tumours, but they are the commonest primary bone tumour diagnosed, with a bimodal age distribution. Since the 1980s, international data suggests 5-year OS rates of between 60% and 70% in patients with non-metastatic osteosarcoma of the extremities.[3] Standard of care for osteosarcoma at present includes multi-drug chemotherapy followed by surgery and adjuvant chemotherapy. The suggested factors include: age at diagnosis, site of primary disease, type of surgery and response to neoadjuvant chemotherapy.[4,5,6,7,8,9] Very little is available in the literature on HIV status and its effect on long-term outcomes in these patients.[10]. Predictive factors for long-term outcomes in osteosarcoma patients are still controversial. There is no literature available regarding these factors in a patient population in a developing country
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