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Limb-sparing in patients with non-metastatic high-grade osteosarcoma.
J BUON 2009 Jan-Mar; 14(1):63-9JB

Abstract

PURPOSE

To improve survival rates and functional outcome in patients with non-metastatic, high-grade osteosarcoma of the extremities, using the Scandinavian Sarcoma Group XIV neoadjuvant chemotherapy protocol.

PATIENTS AND METHODS

The analysis included 37 patients treated during the period 2000-2005. Age range was 8 to 65 year (median 23). Seven (7/37) patients were excluded from the study. The remaining 30 patients received 2 cycles of preoperative chemotherapy (high dose methotrexate, cisplatin and doxorubicin). Surgery was carried out in the 9th week. Twenty-seven (90%) patients had limb-salvage operation and in the remaining 3 amputation was performed. Based on the histopathological assessment of the removed tumor patients were classified in two groups (regarding good or poor response to chemotherapy). All 30 patients received 3 courses of postoperative chemotherapy with the same regimen. Patients with poor response received 3 more cycles of chemotherapy with high dose ifosfamide. Follow-up was 2-8 years (mean 52 months).

RESULTS

Histopathological assessment showed poor response to neoadjuvant chemotherapy in 57% of the patients but no significant difference in 3-year survival between the 2 groups was noted. Three-year survival of the patients with local recurrence was 40 vs. 88% of those without local recurrence (p=0.013). Three-year survival of the patients with distant metastases was 20 vs. 92% of those without distant metastases (p=0.0002). Three-year overall survival (OS) was 80% and disease-free survival (DFS) 60% for all 30 patients.

CONCLUSION

Neoadjuvant chemotherapy in patients with high-grade osteosarcoma of the extremities gives the opportunity for limb-sparing operation and at the same time improves survival rates.

Authors+Show Affiliations

Department for Musculoskeletal Tumors, University Clinic for Orthopaedic Surgery, Skopje, FYROMakedonia. milan_samardziski@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19373949

Citation

Samardziski, M, et al. "Limb-sparing in Patients With Non-metastatic High-grade Osteosarcoma." Journal of B.U.ON. : Official Journal of the Balkan Union of Oncology, vol. 14, no. 1, 2009, pp. 63-9.
Samardziski M, Zafiroski G, Tolevska C, et al. Limb-sparing in patients with non-metastatic high-grade osteosarcoma. J BUON. 2009;14(1):63-9.
Samardziski, M., Zafiroski, G., Tolevska, C., Zafirova-Ivanovska, B., Kostadinova-Kunovska, S., & Kalicanin-Markovska, M. (2009). Limb-sparing in patients with non-metastatic high-grade osteosarcoma. Journal of B.U.ON. : Official Journal of the Balkan Union of Oncology, 14(1), pp. 63-9.
Samardziski M, et al. Limb-sparing in Patients With Non-metastatic High-grade Osteosarcoma. J BUON. 2009;14(1):63-9. PubMed PMID: 19373949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Limb-sparing in patients with non-metastatic high-grade osteosarcoma. AU - Samardziski,M, AU - Zafiroski,G, AU - Tolevska,C, AU - Zafirova-Ivanovska,B, AU - Kostadinova-Kunovska,S, AU - Kalicanin-Markovska,M, PY - 2009/4/18/entrez PY - 2009/4/18/pubmed PY - 2009/6/12/medline SP - 63 EP - 9 JF - Journal of B.U.ON. : official journal of the Balkan Union of Oncology JO - J BUON VL - 14 IS - 1 N2 - PURPOSE: To improve survival rates and functional outcome in patients with non-metastatic, high-grade osteosarcoma of the extremities, using the Scandinavian Sarcoma Group XIV neoadjuvant chemotherapy protocol. PATIENTS AND METHODS: The analysis included 37 patients treated during the period 2000-2005. Age range was 8 to 65 year (median 23). Seven (7/37) patients were excluded from the study. The remaining 30 patients received 2 cycles of preoperative chemotherapy (high dose methotrexate, cisplatin and doxorubicin). Surgery was carried out in the 9th week. Twenty-seven (90%) patients had limb-salvage operation and in the remaining 3 amputation was performed. Based on the histopathological assessment of the removed tumor patients were classified in two groups (regarding good or poor response to chemotherapy). All 30 patients received 3 courses of postoperative chemotherapy with the same regimen. Patients with poor response received 3 more cycles of chemotherapy with high dose ifosfamide. Follow-up was 2-8 years (mean 52 months). RESULTS: Histopathological assessment showed poor response to neoadjuvant chemotherapy in 57% of the patients but no significant difference in 3-year survival between the 2 groups was noted. Three-year survival of the patients with local recurrence was 40 vs. 88% of those without local recurrence (p=0.013). Three-year survival of the patients with distant metastases was 20 vs. 92% of those without distant metastases (p=0.0002). Three-year overall survival (OS) was 80% and disease-free survival (DFS) 60% for all 30 patients. CONCLUSION: Neoadjuvant chemotherapy in patients with high-grade osteosarcoma of the extremities gives the opportunity for limb-sparing operation and at the same time improves survival rates. SN - 1107-0625 UR - https://www.unboundmedicine.com/medline/citation/19373949/Limb_sparing_in_patients_with_non_metastatic_high_grade_osteosarcoma_ L2 - http://www.diseaseinfosearch.org/result/5489 DB - PRIME DP - Unbound Medicine ER -