RESUMEN
The European Musculo Skeletal Oncology Society (EMSOS) has carried out a retrospective review of patients over the age of 40 years with osteosarcoma. 481 patients from 12 centres or multicentric groups were included. 42 patients had osteosarcoma arising in Paget's disease, median survival was 9 months. Patients with axial or metastatic tumours also did badly whilst 41 patients with radiation-induced osteosarcoma had a prognosis paralleling conventional osteosarcoma matched for patient age and site of the tumour. 238 patients had high grade non-metastatic osteosarcoma and had a survival of 46% at 5 years. Older patients had less chemotherapy and fared worse. Osteosarcoma in the elderly is a curable condition and warrants intensive treatment with chemotherapy and surgical resection.
Asunto(s)
Neoplasias Óseas/mortalidad , Osteosarcoma/mortalidad , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Neoplasias Óseas/etiología , Neoplasias Óseas/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Neoplasias Inducidas por Radiación/mortalidad , Neoplasias Inducidas por Radiación/terapia , Osteítis Deformante/mortalidad , Osteítis Deformante/terapia , Osteosarcoma/etiología , Osteosarcoma/terapia , Pronóstico , Estudios Retrospectivos , Distribución por Sexo , Análisis de SupervivenciaRESUMEN
From the European Osteosarcoma Intergroup study 202 patients were assessed with respect to their surgical treatment. Although treated in three different centres the survival of the three groups was identical (57% at five years). Two of the centres had rates of limb salvage of 85% and 83%, respectively, while the third had a rate of 49%. The corresponding risks of local recurrence were 13.3%, 6.8% and 2.5%, with all local recurrences arising in limbs with attempted limb salvage. Local recurrence was closely related to the adequacy of the margins of excision and to the chemotherapeutic response. Patients who had undergone limb-salvage surgery and who developed local recurrence still had a better survival than those who had primary amputation (37% v 31% survival at five years). Of patients who relapsed, 31% of those with local recurrence alone were cured by further treatment, as compared with only 10% of those with metastases. Limb-salvage surgery with effective chemotherapy remains the optimum treatment for osteosarcoma.
Asunto(s)
Neoplasias Óseas/cirugía , Huesos de la Pierna , Osteosarcoma/cirugía , Adolescente , Adulto , Amputación Quirúrgica , Neoplasias Óseas/mortalidad , Neoplasias Óseas/patología , Quimioterapia Adyuvante , Niño , Preescolar , Femenino , Fracturas Espontáneas/etiología , Fracturas Espontáneas/cirugía , Humanos , Pierna/cirugía , Recuperación del Miembro , Masculino , Recurrencia Local de Neoplasia , Osteosarcoma/mortalidad , Osteosarcoma/secundario , Factores de Riesgo , Tasa de SupervivenciaRESUMEN
Primary synovial chondromatosis is a relatively uncommon condition. Synovial chondrosarcoma is considered to be very rare and it is not always clear whether the sarcoma develops by malignant transformation of synovial chondromatosis or whether it arises de novo. Differentiation of the two conditions on clinical and radiographic features is not possible and on histological criteria can be difficult. We report the case of a 59-year-old man who, 4 years after a synovectomy for synovial chondromatosis, developed a synovial chondrosarcoma of the hip. The literature is reviewed.