Osteosarcoma treatment results

It was aimed to examine the treatment results of patients with childhood osteosarcoma and to determine the prognostic factors. Oncology files and hospital records of patients under 18 years of age with osteosarcoma who were diagnosed between January 2000 and December 2019, treated in our center, underwent tumor resection, completed treatment, and whose follow-up data could be accessed were retrospectively reviewed. The male/female ratio of patients included in the study was 1.5. The median age of the patients was 12.9 years (6.5-17.9). Metastases were present in 40% of the patients. Fifty-nine patients (65.6%) were given doxorubicin-cisplatin protocol. After June 2015 31 patients (34.4%) were treated with the EURAMOS protocol. Limb sparing surgery was performed in most of the patients (80%). Surgical margins were negative in 94.2%. Necrosis rate was 90% or less in 71.6% of the patients included in the study. The 5-year EFS and OS rates of the patients were 32.9% and 59.6%. The 5-year OS rate under the age of 10 was 79%. The 5-year EFS and OS rates of metastatic patients were 16.9% and 45.7%, respectively. In localized disease, the 5-year EFS and OS rates were 39.9% and 65.3%, respectively. The difference in OS rates between these two groups was highly significant (p=0.009). Relapse was observed in 48.8% of the patients in a median of 10.2 months (2.1-77.7 months). In our study, treatment results and survival rates were found to be similar to those in the literature. Although the follow-up period of the EURAMOS protocol is still short, it has been shown that the success of treatment is higher than the AP protocol in a similar follow-up period (EFS p=0.003, OS p=0.016). The worst prognostic sign in osteosarcoma is metastatic disease. Extremity-sparing surgical approach together with chemotherapy protocol including methotrexate, cisplatin and doxorubicin is effective in osteosarcoma.