title: Osteosarcoma in Finland from 1971 through 1990: a nationwide study of epidemiology and outcome.
abstract: OBJECTIVE
  There have only been a few nationwide studies on the epidemiology and outcome of osteosarcoma. We report the clinical features, treatment, and prognosis of osteosarcoma in Finland for the period 1971-1990.
  
  
  METHODS
  The study material was derived from population-based data from the national Finnish Cancer Registry. 302 osteosarcomas were reported during the study period. Histological slides could be retrieved for 199 cases and from histological re-examination, 139 (83%) of these cases were confirmed as osteosarcoma and were included in the analysis. The mean length of follow-up was 8 (0.1-28) years.
  
  
  RESULTS
  The overall 5-year survival for the whole study population was 58%, with an improvement in survival during 1981-1990 (65%) compared to the period 1971-1980 (47%) (p=0.01). More chemotherapy was administered in the later time period. For metastasis-free survival, diagnosis in the 1970s as opposed to the 1980s (p=0.01) and large tumor size worsened outcome in univariate analysis. Patients who developed metastatic relapse within 10 months of the diagnosis had worse sarcoma-specific survival than those who developed metastases later. Limb-salvage surgery increased from 12% to 23% for patients with a peripheral tumor, with no increase in local relapses.
  
  
  CONCLUSIONS
  We recommend aggressive approach to treat recurrent disease, with a view to further improving survival. In a small country such as Finland it is necessary to concentrate treatment to only a few centers, to ensure a high quality of treatment.
authors.affiliation: Department of Pathology, Helsinki University Central Hospital, Helsinki, Finland. mika.sampo@helsinki.fi
authors.forename: Mika M
authors.initials: MM
authors.lastname: Sampo
authors.forename: Maija
authors.initials: M
authors.lastname: Tarkkanen
authors.forename: Aarne H
authors.initials: AH
authors.lastname: Kivioja
authors.forename: Mervi H
authors.initials: MH
authors.lastname: Taskinen
authors.forename: Risto
authors.initials: R
authors.lastname: Sankila
authors.forename: Tom O
authors.initials: TO
authors.lastname: Böhling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000209:etiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D012516:Osteosarcoma / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D011379:Prognosis