Osteosarcoma of the pelvis

Over a 25-year period we have treated 36 patients with osteosarcoma of the pelvis. Of the tumours, 24 (67%) were primary osteosarcomas and 12 (33%) ar ose either after irradiation or in association with Paget's disease. Six pa tients had a hindquarter amputation and 12 were treated by a limb-salvage p rocedure with intrapelvic excision, The five-year survival rate of all the patients with pelvic osteosarcoma wa s 18%, while for 17 treated by chemotherapy and surgery it was 41%, The pro gnosis for patients presenting with metastases or with secondary osteosarco ma was appalling and none survived after 29 months. No patient over the age of 50 years when seen initially survived for a year. Youth and a good resp onse to chemotherapy along with complete surgical excision offer the best c hance of cure.