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http://dx.doi.org/10.5292/jkbjts.2012.18.2.59

Effect of Preoperative Chemotherapy on Survival in High-grade Localized Osteosarcoma of the Extremity  

Choi, Eun-Seok (Department of Orthopaedic Surgery, Seoul National University College of Medicine)
Han, Ilkyu (Department of Orthopaedic Surgery, Seoul National University College of Medicine)
Cho, Hwan Seong (Department of Orthopaedic Surgery, Seoul National University College of Medicine)
Kim, Han-Soo (Department of Orthopaedic Surgery, Seoul National University College of Medicine)
Publication Information
The Journal of the Korean bone and joint tumor society / v.18, no.2, 2012 , pp. 59-65 More about this Journal
Abstract
Purpose: Multidisciplinary approaches of surgical resection and chemotherapy have been widely used for the treatment of non-metastatic osteosarcomas. We aimed to assess the effect of neoadjuvant chemotherapy for metastasis and disease-specific survival. Materials and Methods: Authors retrospectively reviewed 225 young (<30 years old) and non-metastatic osteosarcoma patients who underwent surgical resection and postoperative chemotherapy between February 1984 and July 2010. Mean age was 14.4 years old (ranged: 4-29 years old) and average follow-up period was 9.1 years (2-28 years). The patients were divided into two groups according to the application of preoperative chemotherapy. Both groups were compared with clinical characteristics, metastasis-free survival and disease-specific survival. Results: All of 225 patients, 32 patients were treated with postoperative chemotherapy and 193 patients were performed preoperative and postoperative chemotherapy. Postoperative chemotherapy group showed significantly high rate of amputation (p<0.001). Metastasis was occurred in 101 patients. Postoperative chemotherapy group indicated significant higher rate of metastasis (69% vs 41%, p=0.004) and early development of metastasis (mean: 11.5 vs 20.3 months, p=0.045) than pre-and postoperative chemotherapy group. Fifty-seven patients were died of osteosarcoma. Postoperative chemotherapy group revealed significant lower rate of 5-year disease-specific survival than pre-and postoperative chemotherapy group (51% vs 84%, p=0.001). Adult (>15 years) and large sized tumor (>8 cm) were meaningful risk factors of metastasis and disease-specific survival. Although, local recurrences were occurred in 13 patients, there was no significant difference. Conclusion: Neoadjuvant chemotherapy offers better disease-specific survival and metastasis-free survival.
Keywords
osteosarcoma; chemotherapy; preoperative chemotherapy; survival;
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