Results

The average time to presentation to the unit, post-onset of symptoms, was 4.5 months. Most patients, 43/61 (70%), presented initially to a hospital or clinic; only 3/61patients (5%) presented first to traditional healers and 15/61 (25%) to a GP. 16 patients (26%) came from other South African provinces and 3 patients (5%) were international. 3 Patients (5%) presented with a pathological fracture. 3/61 (5%) patients were HIV positive, 8 unknown and the rest were HIV negative.

A standard osteosarcoma work-up was performed. 4 patients (7%) were Enneking Stage 2A, 41 patients (67%) were Stage 2B and 16 patients (26%) presented with metastases (Stage 3). Biopsy was performed on average of 3 weeks post-presentation (delay largely due to MRI).

Surgery was undertaken in 46 patients (75%), with the aim of achieving wide local resection margins: 13 (21%) limb salvage procedures and 33 (79%) limb ablations were performed. 4 patients refused further treatment. 54/57 patients (95%) underwent chemotherapy and, of these, 44 (81%) underwent a neo-adjuvant chemotherapy protocol and 2 patients (4%) received post-adjuvant chemotherapy only. 19/61 patients (31%) defaulted follow-up: of these 19 patients, 15 (79%) were amputees, 1 (5%) was a limb salvage patient and 4 (16%) were un-operated.

Two patients developed local recurrence: 1 was treated with amputation & the other with further excision. Palliative Radiotherapy was administered to 2 patients.

In March 2013, 41 patients were contactable. Of these, 17/41 (41%) were alive and of the surviving 17 patients, 9 (81%) were limb salvage patients and 6 (38%) were amputees. Of the 12 patients, who had initially presented with metastases, only I patient (8%) was alive. Only 1 of the 3 patients, who initially presented with pathological fracture, was traceable and alive.

NO DISCLOSURES