Osteosarcoma in Finland from 1971 through 1990 A nationwide study of epidemiology and outcome

Abstract

Background and purpose There have only been a few nationwide studies on the epidemiology and outcome of osteosarcoma. We report the clinical features, treatment, and prognosis of osteosarcoma in Finland for the period 1971-1990.Methods The study material was derived from population-based data from the national Finnish Cancer Registry. 302 osteosarcomas were reported during the study period. Histological slides could be retrieved for 199 cases and from histological re-examination, 139 (83%) of these cases were confirmed as osteosarcoma and were included in the analysis. The mean length of follow-up was 8 (0.1-28) years.Results The overall 5-year survival for the whole study population was 58%, with an improvement in survival during 1981-1990 (65%) compared to the period 1971-1980 (47%) (p = 0.01). More chemotherapy was administered in the later time period. For metastasisfree survival, diagnosis in the 1970s as opposed to the 1980s (p = 0.01) and large tumor size worsened outcome in univariate analysis. Patients who developed metastatic relapse within 10 months of the diagnosis had worse sarcoma-specific survival than those who developed metastases later. Limb-salvage surgery increased from 12% to 23% for patients with a peripheral tumor, with no increase in local relapses.Interpretation We recommend aggressive approach to treat recurrent disease, with a view to further improving survival. In a small country such as Finland it is necessary to concentrate treatment to only a few centers, to ensure a high quality of treatment.

Bufalin induces apoptosis in the U-2OS human osteosarcoma cell line via triggering the mitochondrial pathway

“…OS is prone to aggressive biological behavior and development of distant metastasis (3)(4)(5). The currently used treatment for OS is neo-adjuvant chemotherapy followed by surgical resection, which has improved the five-year survival rate from 20 to 60% (6,7).…”

Early follow-up of a custom non-fluted diaphyseal press-fit tumour prosthesis

“…Due to improvements in chemotherapeutics, patients with malignant bone tumours are living longer and consequently the longevity of the endoprostheses used for reconstruction of their limb is vitally important [1][2][3]. While debate exists regarding the optimal method of fixation of the endoprosthesis to the host bone, many surgeons now prefer using uncemented stems as they allow for biological fixation at the host-stem junction that can respond and change depending on the needs of the patient [5,8,9].…”

“…Currently, limb salvage surgery is accepted as the gold standard in orthopaedic oncology and, following tumour resection, frequently involves limb reconstruction with an endoprosthesis [3,4]. Due to modern advances in chemotherapy, many patients with these and other malignant bone sarcomas will go on to have a relatively normal lifespan [1,2]. Consequently the durability and longevity of these endoprosthetic implants is of great importance [5].…”

“…Current treatment for malignant extremity bone sarcomas such as Ewing's sarcoma or osteosarcoma includes a combination of chemotherapy and limb salvage surgery [1,2]. Currently, limb salvage surgery is accepted as the gold standard in orthopaedic oncology and, following tumour resection, frequently involves limb reconstruction with an endoprosthesis [3,4].…”

A Preliminary Evaluation of Limb Salvage Surgery for Osteosarcoma around Knee Joint

“…The survival rate of osteosarcoma has been significantly improved with the advent of many effective chemotherapeutic drugs since the late 1970s [1], [2]; meanwhile, limb salvage surgery (LSS) has gradually become the mainstay treatment for osteosarcoma [3], [4] because of its functional and physiological benefits over traditional amputative procedures. Besides, LSS has also greatly improved the life quality and enhanced the courage of patients.…”