Osteosarcoma: Oncologic and functional results. A single institutional report covering 22 years

Background and Objectives: The oncologic and functional results in patients treated because of osteosarcoma (OS) were evaluated. Methods: Fifty-one patients with high-grade OS were treated between 1974 an d 1996 at our hospital. All patient records were studied, and the surviving patients were evaluated according to the American Musculoskeletal Tumor So ciety functional rating system. The majority of patients received adjuvant chemotherapy (prior to 1983) or neoadjuvant chemotherapy (from 1983). Until 1987, all patients with extremity OS had ablative surgery, from 1987, the majority had limb-saving surgery. Lung metastases were resected in most cas es. Results: Overall 2-year and 5-year disease-foe survival (DFS) rates were 27 of 51 and 16 of 42, respectively. Patients with vertebral or pelvic OS or contaminated margins after resection had a very bad outcome. In all other s ubgroups, including patients with various types of chemotherapy, response t o chemotherapy, diameter of tumor, presence or absence of metastatic spread , and location of tumor, a 5-year DFS of about 50% was found. Recurrent dis ease in patients who had achieved a 2-year disease-free interval was relati vely low (4/23 patients). Conclusions: Survival in our series was worse than in most other studies. A very bad outcome was found in patients with vertebral or pelvic OS or with contaminated margins after resection. (C) 1999 WiIey-Liss, Inc.