Osteosarcoma in preadolescent patients

The medical records of boys younger than 11 years and girls younger than 10 years of age,vith osteosarcoma of the pelvis or extremity were reviewed, T hirty patients were identified who were newly diagnosed but untreated for o steosarcoma, None of these patients had pulmonary metastases, The same four protocols were used to treat the patients in the current study as were use d to treat adolescents. The event-free and overall survival was calculated and prognostic factors were assessed, The median followup time was 8 years (range, 6-14 years). The results were compared with the results of older pa tients treated with the same protocols and with published results. Fourteen patients had pulmonary metastases (47%); among these patients, four also h ad skeletal metastases (in two of the latter, skeletal metastases appeared before the pulmonary metastases), Event-free survival was 53% and overall s urvival was 57%, This result is comparable with current survival results in adolescent and older patients. Serum alkaline phosphatase and serum lactic dehydrogenase levels before treatment, height percentile greater than 50%, chemotherapy-induced tumor necrosis, surgical procedure, tumor site, tumor histologic features, and patient gender were not prognostic indicators, Th e prognosis for prepubertal patients with osteosarcoma is similar to the pr ognosis of their adolescent and older counterparts, There does not seem to be any indication to treat preadolescent patients with osteosarcoma using a lternate therapies.