Abstract
Purpose:
To assess the outcomes of osteosarcoma cases managed between January 2006 & December 2010 in a tertiary centre.
Methods:
A retrospective review of patient records.
Results.
Twenty eight consecutive cases of osteosarcoma managed over 5 years were reviewed retrospectively. 16 patients were male, and ages ranged from 11 to 69 years, with 20 patients in their 2nd decade. The distal femur was involved in 17 cases and the proximal tibia in 4. Histologically 13 cases were osteoblastic, 4 chondroblastic and the rest other forms of osteosarcoma.
Tumour size varied from 6 to 35 cm, with only 6 less than 10 cm in size.
Metastases were present on admission in 14 cases, and 2 more developed metastases within 2 months. One patient was Enneking Stage IIA, 13 Stage IIB and 14 Stage III at presentation.
3 patients refused any treatment. 4 cases were considered inoperable and died within days. Chemotherapy was started in 17 patients, and 4 additional patients who were considered for chemotherapy defaulted. 17 patients were treated by amputation, achieving local control in all cases at last follow up. A single patient had a wide tumour resection and prosthetic reconstruction. 5 patients are disease free at average 16 months survival, while 3 have survived an average of 13 months with metastases. 9 patients were lost to follow up, 7 are known and 4 are presumed to be dead.
Conclusion:
These results show the problems of managing osteosarcoma in the public sector. Patients are referred far too late, tumours are so large that most require amputation, half the patients have metastases at presentation and some are preterminal. Many patients refuse amputation or default from chemotherapy.
Results of treatment of osteosarcoma in the public sector are discouraging mostly due to late referral. Education of medical personnel to refer suspicious bone lesions without delay is the only way to improve outcomes.
