Chemotherapy in primary osteogenic sarcoma in patients over the age of forty

Abstract

Objective: In this study, we sought to review the clinical and histopathological features and thechemotherapy regimens in osteogenic sarcoma in patients over 40 years of age, and we aimed atidentifying the possible prognostic factors in this particular group of patients.Methods: We reviewed 287 patients with osteosarcoma treated between the year 1986 and 2010. Patients from this group who met the following criteria were considered eligible for our study; presence ofprimary OS, had typical histological and radiographic features of OS, no prior history of cancer or anytreatment elsewhere and no prior history of preexisting bone abnormalities.Results: The KaplaneMeier survival curve for the entire group, with a 95% conŞdence interval, at two andŞve years showed the survival rates as 76.2% and 72.8% respectively. The surgical margin was a signiŞcantfactor affecting the survival. Presence of a pathological fracture also had a signiŞcant effect on the survival rate.Conclusion: Osteogenic sarcoma remains a challenging disease to treat. Despite the expectation thatelderly patients may not tolerate aggressive modern chemotherapy as the younger patients, we believethat patients with primary OS over the age of 40 should be treated aggressively with effective chemotherapy and complete surgical excision whenever possible.Level of evidence: Level IV, therapeutic study© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).