title: [Results of the treatment of pediatric osteosarcoma in the Hungarian population].
abstract: The objective of this report was to estimate long-term outcome and prognostic factors in children and adolescents with osteosarcoma. To evaluate the efficacy of surgery and multiagent chemotherapy for treating osteosarcoma, we reviewed 122 cases (65 males, 57 females, 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. The 5-year OS and EFS were 68% and 61.5%, respectively. 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 that of 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 those 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). 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: Semmelweis Egyetem,, II. sz. Gyermekgyógyászati Klinika, Budapest, Hungary.
authors.forename: Márta
authors.initials: M
authors.lastname: Hegyi
authors.forename: Agnes
authors.initials: A
authors.lastname: Félné Semsei
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Jakab
authors.forename: Imre
authors.initials: I
authors.lastname: Antal
authors.forename: János
authors.initials: J
authors.lastname: Kiss
authors.forename: Miklós
authors.initials: M
authors.lastname: Szendrõi
authors.forename: Mónika
authors.initials: M
authors.lastname: Csóka
authors.forename: Gábor
authors.initials: G
authors.lastname: Kovács
mesh_terms: D000293:Adolescent; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage / Q000706:statistics & numerical data; D008297:Male; D020360:Neoadjuvant Therapy / Q000379:methods; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D010166:Palliative Care / Q000379:methods; D011379:Prognosis; D012307:Risk Factors