title: [Surgical treatment and prognostic analysis of osteosarcoma in adults older than 40 years].
abstract: OBJECTIVE
  To determine the prognostic factors of primary osteosarcoma in adults.
  
  
  METHODS
  This is a review of 54 patients older than 40 years (24 men and 30 women) who were treated between 1998 and 2011 at the authors' institution. Demographic information and follow-up data were obtained and statistically analyzed.
  
  
  RESULTS
  Tumors involved the limbs in 30 patients (55.5%) and axial skeleton in 17 patients (31.5%), and arose from soft tissue in 7 patients (13%). And 6 patients (11.1%) had synchronous metastasis. According to our review, tumors were treated surgically in 52 patients (96.3%). Local recurrence was documented in 14 patients (26.9%). Metastasis after diagnosis appeared in 21 patients (38.9%). In the 52 patients who received the surgical treatment, the 5 year disease-free survival and overall survival rates were 43.7% and 50.4%, respectively.
  
  
  CONCLUSIONS
  Adult patients with primary osteosarcoma had a poor clinical outcome. Inadequate surgical margins, more tumors in the axial location due to high recurrence rates, metastatic disease at presentation, and large tumor volumes were associated with significantly lower survival rates. Aggressive multi-agent treatment regimens might improve survival.
authors: Department of Musculoskeletal Oncology, Peking University People's Hospital, Beijing 100044, China.
authors: Shun
authors: S
authors: Tang
authors: Department of Musculoskeletal Oncology, Peking University People's Hospital, Beijing 100044, China.
authors: Wei
authors: W
authors: Guo
authors: Department of Musculoskeletal Oncology, Peking University People's Hospital, Beijing 100044, China.
authors: Rong-li
authors: RL
authors: Yang
authors: Department of Musculoskeletal Oncology, Peking University People's Hospital, Beijing 100044, China.
authors: Xiao-dong
authors: XD
authors: Tang
authors: Department of Musculoskeletal Oncology, Peking University People's Hospital, Beijing 100044, China.
authors: Da-sen
authors: DS
authors: Li
authors: Department of Musculoskeletal Oncology, Peking University People's Hospital, Beijing 100044, China.
authors: Sen
authors: S
authors: Dong
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D012516:Osteosarcoma / Q000175:diagnosis / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate