Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Adunka, H.
Adult Osteosarcoma: a retrospective study of single center cohort database
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2024. pp. 88
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Brcic Iva
- Godschachner Theresa Marie
- Altmetrics:
- Abstract:
- Introduction: Osteosarcoma, the most prevalent highly malignant tumor of bone, has a bimodal age distribution. At diagnosis, most patients are in their second and third decade of life with a second peak after the age of 40. After the invention of polychemotherapy regimes in addition to radical resection in the 1970s, no improvement regarding therapy modalities occurred in the last decades and the 5-year OS remains stable with around 60%. Material and methods: 79 adult patients with osteosarcoma diagnosed and treated between 2000 and 2020 at the Medical University Hospital of Graz, a reference center for soft tissue and bone tumors, were included. For each patient we registered age, gender, medical history, clinical appearance, radiological findings (location, affected side, number and size of lesion(s), joint involvement), histological type, tumor grading, treatment, occurrence of metastasis, recurrence, follow-up time and outcomes. These parameters were compared with the published literature. In addition, the comparison between the patients under and above the age of 50 years was performed. Results: Out of 79 patients, 31 were male and 48 were female. The median age was 45.8 years (range from 18 to 93 years). At time of diagnosis, 48 (60.8%) patients were under the age of 50 and 31 (39.2%) patients were above 50. Localization included appendicular skeleton in 72 cases and axial skeleton in 7 cases. 56 (70.9%) patients had conventional osteosarcoma, eleven (13,9%) parosteal osteosarcoma, 6 (7.6%) low grade-central osteosarcoma, 2 (2.5%) high-grade surface osteosarcoma and secondary osteosarcoma was diagnosed in 4 (5.1%) patients. The mean time from onset of symptoms until diagnosis was 5.3 months (range from 0.5 to 60 months); 4 tumors were an incidental finding. 70 (88.6%) patients underwent surgery, 46 (58.2%) received chemotherapy, 35 (44.3%) were treated with neoadjuvant and adjuvant chemotherapy in addition to radical resection. 38 (48.1%) patients developed metastasis; local recurrence was seen in eight (10.1%) patients. Mean follow-up time was 50.7 months. 25 (31.6%) patients died of disease (mean time 32.2 months). Conclusion: High grade conventional osteosarcoma is the most common subtype occurring in the adults, most frequently in the knee region. The limb-salvage surgery with implantation of tumor endoprosthesis is a standard treatment option for all patients, whereas the use of chemotherapy in the elderly patients remains low (especially in the group of patients over the age of 50). The older patients more commonly develop metastasis, have higher recurrence rate and time to death is shorter than in the younger age group. Considering increasing life span in the general population and therefore a probable higher incidence of osteosarcoma in the elderly, further studies in the geriatric population with osteosarcoma regarding possible treatment options are warrant.