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KMID : 0613319990050030169
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Journal of the Korean Bone and Joint Tumor Soceity
1999 Volume.5 No. 3 p.169 ~ p.177
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Osteosarcoma in Patients Older than 40 Years
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Rhee Seung-Koo
Woo Young-Kyun
Kang Yong-Koo
Song Seok-Whan
Chung Yang-Guk
Chung Do-Hyun
Lee An-Hi
Yoo Jin-Young
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Abstract
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Osteosarcoma in patients older than 40 years are rate, however they have different clinical, radiological and pathological features from those of younger patients. Sometimes accurate histologic diagnosis is not easy, which is important in determining the correct surgical treatment and appropriate chemotherapy. Since January 1995, 11 patients with osteosarcoma occurring in patients older than 40 years have been diagnosed, treated and followed up for more than 6 months. In contrast to osteosarcoma in children and adolescents, only 4 cases(36.4%) were conventional types, while the others included 2 malignant fibrous histiocytoma-like types, 2 small cell types, 2 periosteal osteosarcomas and 1 giant cell-rich type. Seven cases showed purely osteolytic or predominantly osteolytic bony lesions and 8 were in Enneking stage ⅡB. Performed surgical treatments included 2 amputations, 6 wide resections and reconstructions, and one curettage and autogenous bone graft. In the remaining 2 cases, definitive surgical treatments included not carried out because of old age, multifocal involvement or poor medical tolerance. Neoadjuvant and adjuvant chemotherapies were performed in 9 of 11 patients. At last follow-up, there were 6 continuously disease-free survivals, 3 alive with diseases and 2 died of diseases. The overall cumulative 4-year survival rate calculated using kaplan-Meier’s productlimit method was 59.3%. For improved oncologic outcomes and survivals, early and accurate diagnosis, surgical treatment with adequate margin and neoadjuvant and adjuvant chemotherapy will be necessary.
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KEYWORD
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Osteosarcoma, Older than 40 years, Clinicopathologic features, Oncologic outcome
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