Long-term results of treatment of bone sarcomas in a developing country. Indian perspective of last 3 decades

Abstract

9067 Objectives: Treatment outcomes of patients with two most common primary malignant bone sarcomas (Osteosarcoma and Ewings’ Sarcoma) has changed over last three decades. Few studies have been reported less developed countries. We report here our experience in last 3 decades from a Regional Cancer centre, Cancer Institute (WIA), Chennai, India. Patients and Methods: 897 patients registered from January 1970 to December 1999, 499 were evaluable for survival analysis. 328 were non-metastatic Osteogenic sarcoma and 171 were non-metastatic Ewings sarcoma Event free survival (EFS) rates and 95% confidence intervals (CI) by Kaplan Meier analysis. Prognostic factors were identified by Log-rank statistics, Cox and Logistic regression. Prior to 1985 we had limited access to chemotherapy drugs and radical resection was the treatment offered. After 1985 patients had neo-adjuvant chemotherapy and limb sparing local treatment of primary tumour. Results: On December 2004, 5 years EFS of Osteogenic sarcoma treated during 1970–1985 (n=70) was 0.32 (95% CI 0.26–0.42) which improved to 64% during the latter time period (n=198) which was statistically significant. EFS of Ewings sarcoma 5 years after diagnosis was 0.063 and improved to 0.53 (p< 0.05). Metastatic tumour, large volume disease, chemotherapy response non-compliance to therapy were adverse prognostic factors. Conclusion: Limited resources, multiple constraints and among other difficult factors we had improvement in our supportive care, surgical techniques, radiation therapy. Oncology in a developing country is challenging No significant financial relationships to disclose.