Outcome and factors effecting outcome of osteosarcoma in a low resource country. (491P)


18 Nov 2017


Poster lunch


Deepal Gunasekera


Annals of Oncology (2017) 28 (suppl_10): x149-x152. 10.1093/annonc/mdx675


D.S. Gunasekera1, M. Somathilaka1, P. Abeysinghe2

Author affiliations

  • 1 Paediatric, Adolescents And Young Adults, National Cancer Institute, 10280 - Colombo/LK
  • 2 Clinical Oncology, National Cancer Institute, 10280 - Colombo/LK



Osteosarcoma is the commonest primary bone sarcoma in children, adolescents and young adults (AYA). In developed countries there are excellent outcomes reported in osteoarcoma with 3 year event free survival (EFS) rates exceeding 60%. In these countries presence of metastasis at presentation and poor response to neo adjuvant chemotherapy were the only factors identified as impacting the outcome. However, reports of treatment outcome in resource limited setting are very scanty and the factors impacting the outcome has not been previously described. All patients in Sri Lanka who are under 18 years of age are treated at the National Cancer institute, Sri Lanka (NCISL).


Data was obtained from the NCISL database of all newly registered histologically proven osteosarcoma patients in the paediatric and adolescent unit. Demographic data, dates of first registration, chemotherapy, surgery, last contact and date of an “event” (death, recurrence, progressive disease) were extracted. Chemotherapy delays were defined as when neoadjuvant chemotherapy (NAC) was delayed for more than 12 weeks and adjuvant chemotherapy (AC) was delayed for more than 23 weeks. Delay due to surgery was when time between last NAC and first AC was more than 8 weeks. EFS was calculated with Kaplan Meier curves, and log rank test was used to calculate the level of significance.


Total number of subjects were 33, with 17 males and 16 females. 12 were less than 8 years and 11 more than 8. 23 had tumours in the lower limb, 6 in upper limbs and 5 in chest wall. Only 5 patients had metastatic disease at presentation. None of the patients completed NAC, surgery, AC within the recommended time duration with mean time for each of 15.6, 8.78, 26.58 weeks, respectively. 5 year EFS for all patients was 29.5%. For patients with NAC delay this was 16% vs no delay 78% (p  0.05).


Delays of neoadjuvant chemotherapy > 12 weeks, delays due to surgery of > 8 weeks and metastatic disease at presentation had a significant impact on 5 year EFS, while age, sex, primary site did not have a significant impact.

Clinical trial identification

Legal entity responsible for the study

D S Gunasekera




All authors have declared no conflicts of interest.

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