title: Chemotherapy in primary osteogenic sarcoma in patients over the age of forty.
abstract: OBJECTIVE
  In this study, we sought to review the clinical and histopathological features and the chemotherapy regimens in osteogenic sarcoma in patients over 40 years of age, and we aimed at identifying the possible prognostic factors in this particular group of patients.
  
  
  METHODS
  We reviewed 287 patients with osteosarcoma treated between the year 1986 and 2010. Patients from this group who met the following criteria were considered eligible for our study; presence of primary OS, had typical histological and radiographic features of OS, no prior history of cancer or any treatment elsewhere and no prior history of preexisting bone abnormalities.
  
  
  RESULTS
  The Kaplan-Meier survival curve for the entire group, with a 95% confidence interval, at two and five years showed the survival rates as 76.2% and 72.8% respectively. The surgical margin was a significant factor affecting the survival. Presence of a pathological fracture also had a significant effect on the survival rate.
  
  
  CONCLUSIONS
  Osteogenic sarcoma remains a challenging disease to treat. Despite the expectation that elderly patients may not tolerate aggressive modern chemotherapy as the younger patients, we believe that patients with primary OS over the age of 40 should be treated aggressively with effective chemotherapy and complete surgical excision whenever possible.
  
  
  METHODS
  Level IV, therapeutic study.
authors.affiliation: Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Ozkurt
authors.affiliation: Ankara University, School of Medicine, Ibn-i Sina Hospital, Department of Orthopedics, Oncology Section, Ankara, Turkey.
authors.forename: Kerem
authors.initials: K
authors.lastname: Basarir
authors.affiliation: Ankara University, School of Medicine, Ibn-i Sina Hospital, Department of Oncology, Ankara, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Yalcin
authors.affiliation: Afsin State Hospital, Kahramanmaraş, Turkey. Electronic address: dr.merter@gmail.com.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Merter
authors.affiliation: Ankara University, School of Medicine, Ibn-i Sina Hospital, Department of Orthopedics, Oncology Section, Ankara, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yildiz
authors.affiliation: Ankara University, School of Medicine, Ibn-i Sina Hospital, Department of Orthopedics, Oncology Section, Ankara, Turkey.
authors.forename: Yener
authors.initials: Y
authors.lastname: Saglik
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy; Elderly; Osteogenic sarcoma; Survival rate