Predictors of Survival in Children with Osteogenic Sarcoma Undergoing Limb Salvage Surgery: Experience from a Tertiary Cancer Center in Rural India

• Published in: Indian journal of medical and paediatric oncology 2020-05, Vol.41 (3), p.335-339
• Main Authors: Raghavan, Vineetha, Jithin, TK, Narayanan, Vinin V, Nayanar, Sangeetha K, Balasubrahmanian, Satheesan
• Format: Article
• Language: English
• Subjects: Analysis; Bone cancer; Children; Original Article; Osteosarcoma; Sarcoma; Surgery
• ISSN: 0971-5851; 0975-2129
• DOI: 10.4103/ijmpo.ijmpo_166_18

Abstract Context: Osteogenic Sarcoma (OGS) is the fifth most common malignancy among adolescents aged 15–19. With multimodality therapy, the long-term survival has improved from 16% in the prechemotherapy era to around 70% in the postchemotherapy era. Aim: This study aims to determine the clinical profile and survival of children with OGS being treated with limb-salvage surgery (LSS). Subjects and Methods: This is a retrospective analysis of all cases of OGS (age ≤ 19) who underwent LSS at our center between June 2009 and February 2017. Baseline characteristics were noted and multivariate analysis was performed for various variables to identify predictors of survival. Results: Among 44 cases studied majority were boys ( n = 27). Ninety-three percentage ( n = 41) were adolescents. Stage 2 disease was 75% and Stage 3 disease was 25%. The estimated 3-year overall survival (OS) was 69% (95% confidence interval [CI] 55–86) and the estimated 3-year event-free survival (EFS) was 55% (95% CI = 41–74). OS was significantly improved in patients with >90% necrosis postneoadjuvant chemotherapy (NACT) when compared with 4 cycles (78% vs. 60%, P = 0.04). EFS was significantly better in patients without lung metastasis at presentation (61% vs. 29%, P = 0.04), Stage 2 disease (59% vs. 38%, P = 0.04) and >90% necrosis in the tumor post-NACT (69% vs. 35%, P = 0.02). Conclusion: Significant response to NACT predicted improved OS and EFS in children with OGS treated with LSS.