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Establishment of Cancer Stem Cell Cultures from Human Conventional Osteosarcoma
Published on: October 14, 2016
Initial presentation and management of osteosarcoma, and its impact on disease outcome
Janet Y K Yang1, Frankie W T Cheng, K C Wong
1Department of Paediatrics, Lady Pao Children's Cancer Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Insights
Delayed diagnosis of osteosarcoma in Hong Kong children is common, with many consulting bonesetters first. Increased awareness among the public and medical professionals is crucial for earlier detection and improved outcomes in pediatric osteosarcoma cases.
Area of Science:
- Pediatric Oncology
- Orthopedic Oncology
- Cancer Epidemiology
Background:
- Osteosarcoma is the most common primary bone malignancy in children and adolescents.
- Early diagnosis and prompt treatment are critical for improving survival rates in pediatric osteosarcoma.
Purpose of the Study:
- To evaluate the initial presenting symptoms and management of osteosarcoma in Hong Kong Chinese children.
- To assess the impact of symptom duration and diagnostic delays on disease outcomes in pediatric osteosarcoma.
Main Methods:
- Retrospective study of 51 children diagnosed with osteosarcoma under 18 years old.
- Data collected from a tertiary referral center in Hong Kong between March 1994 and October 2005.
- Analysis of presenting symptoms, time to diagnosis, and correlation with treatment outcomes.
Main Results:
- The median age of onset was 13 years, with 61% males. Common sites were distal femur (45%) and proximal tibia (22%).
- 24% of patients presented with metastatic disease. Swelling (76%) and pain (90%) were primary complaints.
- A significant delay was observed from symptom onset to diagnosis (median 61 days), with 37% initially consulting bonesetters. Diagnostic delays did not correlate with disease outcomes.
Conclusions:
- Initial consultation with bonesetters is prevalent in Hong Kong, contributing to diagnostic delays in pediatric osteosarcoma.
- There is a need to raise public and medical awareness regarding osteosarcoma symptoms in adolescents to facilitate earlier diagnosis.
- Timely medical consultation and diagnosis are essential for optimizing management and outcomes in pediatric osteosarcoma.
Objective:
To evaluate the initial presenting symptoms and management of osteosarcoma in Hong Kong Chinese children, in relation to any possible impact on disease outcomes.
Design:
Retrospective study.
Setting:
A tertiary referral centre of bone cancer in a university teaching hospital in Hong Kong.
Patients:
All children aged younger than 18 years with a diagnosis of osteosarcoma who received treatment from March 1994 to October 2005.
Results:
A total of 51 children were studied. The median age of onset was 13 (range, 3-20) years; 61% were males. The tumours were located in the distal femur and proximal tibia, which accounted for 45% and 22% of the cases, respectively; 24% of patients had metastatic disease at presentation. Swelling (76%) and pain (90%) were the most common presenting complaints. Approximately one third of the patients had a preceding history of trauma. The median duration of initial symptoms to first medical consultation of any sort was 30 (range, 0-360) days. The median time from the first consultation to a definitive diagnosis was 21 (range, 0-350) days; 25% were diagnosed more than 52 days after presentation. Bonesetters were initially consulted by 37% of these patients. From presentation to diagnosis, the median duration was 61 (range, 4-361) days. Analysis of the duration of pre-diagnosis symptoms did not correlate significantly with the development of metastatic disease, response to chemotherapy, feasibility of limb salvage surgery, relapse rates, or survival rates.
Conclusions:
In Hong Kong, initial consultation to bonesetters was common. A relatively long delay in between symptom onset and diagnosis of osteosarcoma was encountered. The public and medical practitioners should be made aware of this disease, especially in adolescents.
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