Osteosarcoma: Where do we stand? A 10 year follow up of 110 cases
|IJOCP | Volume – 2015| Issue – 2015| Article ID – 2015:71
Conference: Indian Orthopaedic Association Annual Conference IOACON-2013, India [Click for Full details]
Authors: Sivasankar P, Sugath K C, Geothe J
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Introduction: The use of potent chemotherapeutic drugs, better imaging modalities and improved surgical techniques has increased the life expectancy of patients with osteosarcoma to a great extend. The study was done to evaluate the spectrum of osteosarcoma, the various factors which affected the prognosis and to compare our results with set international standards.
Materials & Methods: 110 patients with osteosarcoma treated in our institute from 2001 – 2010 were included inthe study. The group included patients in the age group of 2 – 65 years and 62 of them were males. Long bone was affected in the majority of the cases with distal femur being the commonest site. 106 patients underwent limb salvage procedures as appropriate for the site of lesion. Data was analysed to find out if the various parameters had any influence on the outcome of the patient. Our results were then compared with the accepted international standards
Results, Conclusions: Proximally located lesions did have the same prognosis as distally based lesions. Average volume of the tumours in this study group was 3 626 cm which is 2.2 times that of international standards. There was no difference with respect to biopsy tract infiltration between open and closed biopsy but local recurrence was seen more in patients who had undergone open biopsy. Pulmonary metastasis was seen in patients with tumour volume > 860 cm and as known patients presenting with pulmonary and skeletal metastasis showed poor prognosis. Patients presenting with pathological fractures had more risk for local recurrence but there was no difference in overall survival. Average resection length was 18.2 cm but there was no difference in EFS or DFS with respect to respect to resection length. 37% of patients had tumour necrosis more than 90% and those with necrosis less than 60% had poor prognosis. Surgical margin was positive in 2 cases and ended in subsequent local recurrence. Our local recurrence rate of 7.3% (8 patients) is within the accepted international standards. 2 year disease survival of 73.3% is below that attained in many international centres. In spite of operating on larger tumours the overall results of this study is comparable to that of international standards. But study must be carried out to find reasons for the decreased 2 year survival in our study group and whether any changes need to be made in the chemotherapy regime. Urgent research needs to be initiated why majority of patients came from northern part of Kerala and from one particular community of our state.
|How to Cite this Abstract|
|Sivasankar P, Sugath K C, Geothe J. Osteosarcoma: Where do we stand? A 10 year follow up of 110 cases. International Journal of Conference Proceedings 2015;(2015):71|