Evaluation of neoadjuvant chemotherapy for patients with stage II osteosarcoma / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To retrospectively review the effect of chemotherapy and survival rate of osteosarcoma in extremity.</p><p><b>METHODS</b>Between July 1997 and July 2007, 296 patients with osteosarcoma received neo-adjuvant chemotherapy and surgery. There were 184 males and 112 females, with age between 7 and 65 years. The tumors located in proximal femur in 10 patients, diaphyseal of femur in 7, distal femur in 148, proximal tibia in 80, distal tibia in 5, fibula in 11, humerus in 33, and distal radius in 2 patients. According to Enneking stage system, 6 patients were in stage IIA and others in stage IIB. All patients received evaluation of preoperative chemotherapy, and 72 patients had analysis of tumor necrosis after operation.</p><p><b>RESULTS</b>After mean follow-up of 47 months, metastasis developed in 98 (33.1%) patients. The metastatic rate was 15.5%, 31.0%, and 77.1% in patients with substantial effective chemotherapy, partial effective chemotherapy, and no effective chemotherapy, respectively. In tumor necrosis analysis, reduction of tumor volume and more clear margin after preoperative chemotherapy were related to higher tumor necrosis.</p><p><b>CONCLUSIONS</b>The patients with osteosarcoma should receive chemotherapy as soon as possible. More effective chemotherapy means lower metastatic rate and higher no event survival rate.</p>