Primary Osteogenic Sarcoma in Patients over than Forty Years

Abstract

Objectives: Osteogenic sarcoma has a well recognized double peak of incidence, beside being the most common childhood malignancy of bone, there is a significant second peak in the seventh and eighth decades of life. We sought to review the clinical and hisopathological features also chemotherapy regimens in this particular group of patients and to determine possible prognostic factors. Materials and Methods: We reviewed 287 patients of osteosarcoma treated between 1986 and 2010.Patients were considered eligible for the present study if they fulfilled the following criteria: primary OS, typical histological and radiographic features of OS, no prior history of cancer or treatments elsewhere, and no prior history of pre-existing bone abnormalities. Results: The Kaplan-Meier survival curve for the entire group including 95% confidence limits at two and five years. The overall two- and five-year survival rates were 76.2% and 72.8%, respectively. Surgical margin was a significant factor affecting survival. Also pathological fracture was a significant factor affecting the survival. Discussion: The decreasing incidence of OS over the age of 40 years and the expectation that these elderly patients may not tolerate aggressive modern chemotherapy means that the patients with OS over the age of 40 years may must often excluded from current trials of treatment. Osteogenic sarcoma remains a challenging disease to treat. A multidisciplinary approach is the best method for treating OS in patients older than 40 years. The poor clinical outcome in elderly patients with primary OS reported previously is difficult to understand. Level of Evidence: Level 3 Keyword: Osteogenic Sarcoma, Elderly Patients DOI: 10.3944/AOTT.2016.16.0035 This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.