Effect of Preoperative Chemotherapy on Survival in High-grade Localized Osteosarcoma of the Extremity.
10.5292/jkbjts.2012.18.2.59
- Author:
Eun Seok CHOI
1
;
Ilkyu HAN
;
Hwan Seong CHO
;
Han Soo KIM
Author Information
1. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea. hankim@snu.ac.kr
- Publication Type:Original Article
- Keywords:
osteosarcoma;
chemotherapy;
preoperative chemotherapy;
survival
- MeSH:
Adult;
Amputation;
Extremities;
Follow-Up Studies;
Humans;
Neoplasm Metastasis;
Osteosarcoma;
Recurrence;
Retrospective Studies;
Risk Factors
- From:The Journal of the Korean Bone and Joint Tumor Society
2012;18(2):59-65
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Multidisciplinary approaches of surgical resection and chemotherapy have been widely used for the treatment of non-metastatic osteosarcomas. We aimed to assess the effect of neoadjuvant chemotherapy for metastasis and disease-specific survival. MATERIALS AND METHODS: Authors retrospectively reviewed 225 young (<30 years old) and non-metastatic osteosarcoma patients who underwent surgical resection and postoperative chemotherapy between February 1984 and July 2010. Mean age was 14.4 years old (ranged: 4-29 years old) and average follow-up period was 9.1 years (2-28 years). The patients were divided into two groups according to the application of preoperative chemotherapy. Both groups were compared with clinical characteristics, metastasis-free survival and disease-specific survival. RESULTS: All of 225 patients, 32 patients were treated with postoperative chemotherapy and 193 patients were performed preoperative and postoperative chemotherapy. Postoperative chemotherapy group showed significantly high rate of amputation (p<0.001). Metastasis was occurred in 101 patients. Postoperative chemotherapy group indicated significant higher rate of metastasis (69% vs 41%, p=0.004) and early development of metastasis (mean: 11.5 vs 20.3 months, p=0.045) than pre-and postoperative chemotherapy group. Fifty-seven patients were died of osteosarcoma. Postoperative chemotherapy group revealed significant lower rate of 5-year disease-specific survival than pre-and postoperative chemotherapy group (51% vs 84%, p=0.001). Adult (>15 years) and large sized tumor (>8 cm) were meaningful risk factors of metastasis and disease-specific survival. Although, local recurrences were occurred in 13 patients, there was no significant difference. CONCLUSION: Neoadjuvant chemotherapy offers better disease-specific survival and metastasis-free survival.
