1515 - Predictors of survival in adolescents and young adults with non metastatic extremity osteosarcoma- cancer institute (WIA), a tertiary cancer center...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Cancer in Adolescents
Cancer in Young Adults
Sarcoma
Presenter Rejiv Rajendranath
Authors R. Rajendranath1, K. Narayanaswamy2, S.G. Tenali1
  • 1Medical Oncology, Cancer Institute (WIA), 600036 - Chennai/IN
  • 2Surgical Oncology, Cancer Institute (WIA), 600036 - Chennai/IN

Abstract

Osteosarcoma one of the highly curable malignancy is the most common primary malignant neoplasm of bone in adolescents and young adults. The purpose of this study was to determine the predictors of survival in patients with non metastatic Extremity Osteosarcoma.

Methods

The study was a retrospective analysis of 272 consecutive patients diagnosed between 1998 and 2008 and 232 of them who had undergone protocol treatment was included for predictors of survival anal.

Results

Median age of the patients was 17 years (6-52) and males constituted 60 % (n = 163). Distal femur was the commonest site, 49.4% (n = 134) followed by proximal tibia 39.5% (n = 107). Classical osteosarcoma was the commonest subtype 56% (n = 152) followed by Pleomorphic 21% (n = 57) and chondroblastic variant 16.6%9 (n = 45). Majority of the tumours were high grade 96.3% (n = 262).156 (57.6%) patients received Neoadjuvant Chemotherapy and 184 (65%) received ≥ 4 cycles of planned Chemotherapy. 116 (42.4%) of patients underwent limb salvage surgery (LSS). The proportion of patients undergoing LSS improved from 45.3% to 53.2% during the time periods 1998-2002 and 2003-2008 respectively. Febrile Neutropenia was noted in 15 % and 3 patients died due to Chemotherapy related toxicities. Of 156 patients who received neoadjuvant chemotherapy 100 % necrosis was seen in 20 (12.8%) and >90% necrosis in 31 (19.8%). 5 year Disease free survival and overall survival among non metastatic osteosarcoma was 52.9% and 55% respectively.Significant factors for predictors of survival included Age <14 years (p = 0.02), Distal Femur site (p = 0.007), type of surgery, LSSv/s amputation (60.5% v/s 37.9%) and >90% necrosis (79.8% v/s 42.2% p = 0.001). Among Neoadjuvant Chemotherapy patients who received 3-4 cycles of Preoperative Chemotherapy did significantly better than those whoreceived ≥ 5cycles. (62.4% v/s 46.1% p = 0.036).

Conclusions

Predictivefactors that implicate adverse survival in non metastatic osteosarcoma in our patients include Age <14 years, Proximal Humerus tumours, <90% Necrosis after Neoadjuvant Chemotherapy, and patients not receiving planned 3-4 cycles of Preoperative Chemotherapy. Patients who underwent amputation due to late presentation and amputation had an adverse effect on survival.

Disclosure

All authors have declared no conflicts of interest.