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Long term results in localized osteosarcoma :Major importance of initial management

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Long term results in localized osteosarcoma :Major importance of initial management
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Long term results in localized osteosarcoma :

Major importance of initial management A monocentric retrospective analysis.

Delepine N., Alkhallaf S,Markovska B. Cornille H. ,TabbiA.,Delépine N.

Oncologic Paediatric Unit. Raymond poincaré University Hospital 92380 Garches- France -



EFORT Nice du 29 au 31 mai 2008



Patients

55 patients had the biopsy performed by the surgeon of the team

 after local evaluation of the tumor and planning of future en bloc resection.



Excisional contaminated biopsies

3 patients were primarily amputated

 all in referred patients

 among them 2 seen after inadapted biopsy

Local treatment

 All the 136 others were treated by limb salvage even for

 fractured or

 huge tumors

 or in very young patients

Results : Local control

 All patients received preoperative and postoperative chemotherapy according to the current protocols at the time of their treatment.

 All patients were followed up by their surgeon and their chemotherapist. median follow up of 15 years (maximal 23 - minimal 10)

 13 local recurrences were observed :

- 11/84 (13 %) in referred patients and

- 2/55 (3.6 %) in first hand patients.

- This difference is significant P<0,02

(No significant differences in initial prognosis factors were observed between the two groups)

Local Control

88 %for referred patients

Survival





Conclusion 1

 Initial management by an experimented team is of crucial importance in long term local control and survival of patients with localized high grade osteosarcoma of the limb..

 When the diagnosis of osteosarcoma can not be excluded on prebiopsy medical imaging of bone tumor, the patient should be referred, before biopsy, to team experimented in bone tumor oncology.





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