Evaluation of treatment results in our osteosarcoma patients retrospectively

ABSTRACT Background: Primary bone malignancies constitute less than 1% of all cancers. Osteosarcoma is the most common type of all primary bone cancer . It usually affects adolescents and young adults. The mortality increases if treatment ıs not proper and suffient. For this reason extensive studies have been conducted.İn 1960s survival rates were %20, however nowadays it reachs to %70 in localized ekstremity osteosarcoma. The major factors in the increase in survival rates have been developments in neoadjuvan and adjuvant CT. In the last 25 years, because of development in imaging techniques and surgical techniques, amputations have been largely replaced by limb-sparing surgical techniques. Methodology: In our study, 114 patients who was applied to EUTF Orthopedics and Traumatology Clinic between 1.1.2000 - 31.12.2015, taken pathological diagnosis as osteosarcoma, received oncologic treatment at EUTF and continued to follow-up in our clinic.We recorded local recurrence and metastasis, operative features, postoperative complications, type of prosthesis, revision status, , age, gender, history of complaints, location of resection,tumor size, pathologic fracture status, CT response, neoadjuvant- adjuvant treatment by time and proportion.The relationship between these informations and survival rates were investigated. Results: The mean age is 26.6 ± 16.8, Male- Female ratio is 1.23, 94.7% of all cases are located on the extremity and the most frequent location is the distal femur (52.6%). Pain and swelling association are the most common complaints (57.5%), and duration of swelling is correlated with stage. Limb-sparing surgery is the most common surgery with 75.4%, and stage 2b is the most common disease. By the time of diagnosis, metastasis is detected in 35.5% and 14 (13%) of 107 patients have local recurrence after operation. 39.7% patients who have prosthesis were revised. The most frequent reason of the revision is infection, the most common infection is Staphylococcus aureus. Overall survival is 77.2% for 2 years, 56.5% for 5 years and 50.6% for 10 years. Disease free survival rates are found as 76.3%, 41.6% and 36.9% respectively. Diagnostic factors are presence metastatic disease at first biopsy, local recurrence, postoperative metastatic disease, necrosis rate of tumor after resection, stage of tumor at diagnosis. Conclusion: By the time of diagnosis, the presence of metastatic disease, an increase in the stage, tumor necrosis <90%, presence of local recurrence, postoperative metastatic disease are the factors that decrease the survival rates. There is no relationship between limb salvage surgery and amputation in terms of survival rates and local recurrence.