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Clinical and Prognostic Characteristics in Childhood Osteosarcoma: A Single-Center Experience in Türkiye
Mert Altıntaş1, Emel Cabi Ünal2, Nurdan Taçyıldız2
1Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Insights
This study on osteosarcoma in pediatric patients found that delayed diagnosis and metastatic disease significantly increase recurrence and mortality risks. Early intervention and multidisciplinary approaches are crucial for improving outcomes in this common bone cancer.
Area of Science:
- Pediatric Oncology
- Orthopedic Oncology
- Bone Tumors
Background:
- Osteosarcoma is the most common primary malignant bone tumor in children and adolescents.
- Clinical experiences and outcomes for osteosarcoma patients require ongoing evaluation.
Purpose of the Study:
- To report clinical experiences with osteosarcoma at a single center.
- To identify factors influencing recurrence, mortality, and survival rates in pediatric osteosarcoma patients.
Main Methods:
- Retrospective analysis of 59 pediatric osteosarcoma cases (2007-2021).
- Evaluation of diagnostic delays, metastatic status, surgical interventions, chemotherapy response, and treatment complications.
- Calculation of 5-year overall and disease-free survival rates.
Main Results:
- Mean diagnostic delay was 3 months; shorter delays showed trends toward higher recurrence and mortality.
- 59.3% of patients had metastatic disease, associated with increased recurrence and mortality.
- Amputation as initial surgery, multiple operations, and poor chemotherapy response correlated with higher mortality.
- 42.4% mortality rate; 5-year survival rates were 47.5% (overall) and 30.5% (disease-free).
- Renal problems and cardiotoxicity were common treatment complications.
Conclusions:
- Metastatic disease and poor chemotherapy response are critical factors for osteosarcoma mortality.
- While survival has improved, further multicenter, multidisciplinary studies are essential for advancing osteosarcoma treatment.
- Optimizing diagnostic timelines and treatment strategies can improve pediatric osteosarcoma patient outcomes.
Abstract:
In our study, we aimed to share the clinical experiences of our center regarding osteosarcoma cases, the most common primary malignant bone tumor in children and adolescents. With approval from the Clinical Research Ethics Committee of our center, the data of 59 pediatric patients who were followed up in our center with the diagnosis of osteosarcoma between 2007 and 2021 were evaluated retrospectively. The mean time between the onset of symptoms and diagnosis was 3 months. Although not statistically significant, patients with a diagnostic delay of 3 months or less had a higher rate of recurrence and mortality. 59.3% of patients had metastatic disease, and the presence of metastases was associated with higher rates of recurrence and mortality. Significant number of patients had multiple surgical operations. Amputation as the first operation and the need for multiple surgeries were associated with higher mortality. Pathologically poor response to chemotherapy is associated with mortality. 42.4% of patients died, and the 5-year overall and disease-free survival rates were 47.5% and 30.5%, respectively. Survival rates were highest in non-metastatic and non-relapsed patients, and lowest in metastatic patients and patients with poor response to chemotherapy. Renal problems and cardiotoxicity were most frequently treatment-related complications. Significant improvements have been achieved in the survival and quality of life in osteosarcoma cases compared to previous years; however, there is still a long way to go, and more multicenter and multidisciplinary studies are needed on osteosarcoma.
