title: Good prognosis of localized osteosarcoma in young patients treated with limb-salvage surgery and chemotherapy.
abstract: BACKGROUND
  The objective of this report was to estimate long-term outcome and prognostic factors in children and adolescents with osteosarcoma. A large group of osteosarcoma patients were analyzed at our national oncology center.
  
  
  METHODS
  To evaluate the efficacy of surgery and multiagent chemotherapy for treating osteosarcoma, we reviewed 122 cases (65 male, 57 female, mean age 13.8 ± 3.6 years) treated at the Second Department of Pediatrics in Budapest between 1988 and 2006. Demographic parameters, tumor-related and treatment-related variables, response, overall survival (OS) and event-free survival (EFS) were analyzed.
  
  
  RESULTS
  The 5-year OS was 68% and 5-year EFS was 62%. OS of patients without metastasis was 79%, while OS with early metastasis was 17%. Survival of patients with amputation (n = 30) was not significantly different from patients with limb-salvage surgery (n = 82), but all patients without radical surgery died. Gender and histological classification had no prognostic significance. Patients with localized tumors in extremities had increased survival compared to patients with axial skeleton tumors (P = 0.013). Poor histological response to neoadjuvant chemotherapy (rate of survivor tumor cells >10%) was associated with decreased survival (P = 0.018). Patients under 14 years had better EFS than patients over 14 years (P = 0.008).
  
  
  CONCLUSIONS
  Our results demonstrate that younger patients with localized osteosarcoma of the extremities who receive limb-salvage surgery and chemotherapy have an excellent survival.
authors.affiliation: 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary. marta.hegyi@gmail.com
authors.forename: Marta
authors.initials: M
authors.lastname: Hegyi
authors.forename: Agnes F
authors.initials: AF
authors.lastname: Semsei
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Jakab
authors.forename: Imre
authors.initials: I
authors.lastname: Antal
authors.forename: Janos
authors.initials: J
authors.lastname: Kiss
authors.forename: Miklos
authors.initials: M
authors.lastname: Szendroi
authors.forename: Monika
authors.initials: M
authors.lastname: Csoka
authors.forename: Gabor
authors.initials: G
authors.lastname: Kovacs
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000671:Amputation, Surgical / Q000401:mortality; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D023821:Limb Salvage / Q000401:mortality; D008297:Male; D009362:Neoplasm Metastasis; D012516:Osteosarcoma / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents