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Osteosarcoma: experience of the Pediatric Oncology clinic of the Santa Casa de Misericórdia Hospital in São Paulo

OBJECTIVES: To describe clinical and laboratorial features of children and adolescents with osteosarcoma seen at the Pediatric Oncology clinic of the Santa Casa de Misericórdia Hospital in São Paulo and to determine the uneventful rates of survival and the overall survival, and correlate such rates to the main factors of prognosis. METHODS: Retrospective study carried out at the Pediatric Oncology clinic of the Santa Casa de Misericórdia Hospital in São Paulo from April 1991 to September 2002. 60 cases of osteosarcoma were identified in the period. The authors saw a predominance of the male sex (61.7%), non-white race (65%), and age above 10 years (70%); history of previous trauma in 53.3%, reporting pain in 95%, and volume increase in 80% of the cases. The knee joint was the involved region in most cases (74.9%). In 70.7% of the cases, the tumor was smaller than 1/3 of the bone affected, in 25% the serum lactic dehydrogenase level was equal to or greater than 500U/L, and in 48.3%, the alkaline phosphatase level was equal to or greater than 1000U/L, 25% of the patients presented with lung metastasis that was visible in the diagnosis, and 53.3% were of the osteoblastic subtype. Pre and post surgical chemotherapy was conducted in 78.3% of the patients, 64% were submitted to conservative surgery, 68.1% had tumoral necrosis grades I and II, and recurrence was seen in 60% of the cases. RESULTS: With a 48 month follow-up, they observed disease-free survival in 28.6% of the patients, and overall survival in 38.4%. CONCLUSIONS: They concluded that early diagnosis is a must, and that new studies are required to improve the management and treatment of this patients and to improve survival.

Osteosarcoma; Survivorship (Public Health); Prognosis; Child; Retrospective studies


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