Témoignage Intégral de Carine Curtet
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Témoignage Intégral du Dr Delépine
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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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