Purpose: The aim of the study was to document the trends in survival from childhood osteosarcoma in Scotland using clinical data held in the Scottish Bone Tumor Registry from 1933 onwards.

Methods and Results: From 217 osteosarcoma patients identified in Scotland aged 18 and under with case notes in the BTR, 184 with non-metastatic appendicular disease were included in the analysis. Kaplan Meier curves were constructed and log rank statistics calculated for univariate analysis. Multivariate analysis was performed using the Cox regression proportional hazards model.

Epidemiological figures reflect those of other studies. The male: female ratio was 1.4: 1, most common age at diagnosis was 16 – 18 and the most common site of tumor was the distal femur, 71% of tumors occurred at the knee. 5 year and median survival were 30% and 26 months for the entire period. 5 year survival was found to have improved from 21% between 1933–1959 to 62% in 1990 – 1999. On univariate analysis the most significant factor influencing outcome was use of chemotherapy in treatment (p< 0.00005). On multivariate analysis, date of diagnosis had most influence on the hazard ratio, the greatest difference being found between diagnoses pre and post – 1980. Site of tumor was also found to be a significant factor (p=0.044). The survival from Osteosarcoma in Scotland in recent years was found to be no worse than the rest of the UK as had previously been suggested.

Conclusion: Survival from childhood osteosarcoma in Scotland has improved significantly from the 1930s to the present day. This is largely due to the introduction of effective chemotherapy protocols into the treatment regimen. These improvements reflect those seen in other countries over the same period.