Telangiectatic osteosarcoma of the extremity - Neoadjuvant chemotherapy in24 cases

Between April 1990 and December 1994, we treated 24 patients with telangiec tatic osteosarcoma (TO) of the extremities with neoadjuvant chemotherapy us ing 2 protocols, Surgery consisted of limb salvage in 21 patients and amputation or rotation plasty in 3, The histologic response to chemotherapy was good (90% or more tumor necrosis) in 23 patients, of whom 12 had total necrosis, With a mean follow-up of 74 (60-96) months, 20 patients remained continuously free of disease and 4 relapsed with lung metastases, There were no local recurrence s, Comparing these results to the ones achieved in 269 contemporary patient s with conventional osteosarcoma of the extremities using the same protocol s for chemotherapy, we found a significantly better histologic response to chemotherapy (96% vs 68% of good histologic response; p = 0.004) and diseas e-free survival (83% vs 55%; p = 0.01) in the TO group, We conclude that TO, once considered a lethal tumor, seems to be even more sensitive to chemotherapy than conventional osteosarcoma, and that most of these patients may be cured without amputation.