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.