J Korean Med Sci.  2006 Aug;21(4):715-718. 10.3346/jkms.2006.21.4.715.

Primary Osteosarcoma in Patients Older than 40 Years of Age

• Jeon DG
• Lee SY
• Cho WH
• Song WS
• Park JH

• KMID: 2157826
• DOI: http://doi.org/10.3346/jkms.2006.21.4.715

Abstract

Among the 665 patients who registered at our hospital, we reviewed 39 cases of high grade primary osteosarcoma in patients who were older than 40 yr of age. The aim of this study was to determine if a primary osteosarcoma in older patients has different clinical features, and a poorer prognosis than in younger patients. Two evaluations were performed. In the first, an attempt was made to determine the possible prognostic factors such as gender, location, size, alkaline phosphatase, radiological findings, chemotherapy intensity, chemotherapy-induced tumor necrosis, and surgical margin. The second evaluation involved assessment of whether there were any significant clinical differences between older patients and adoles-cents. According to the results, a primary osteosarcoma in older patients did not reveal any significant prognostic variables. A primary osteosarcoma in older patients showed a poorer prognosis due to relatively unusual locations, common abnormal radiological findings, and a poor response to chemotherapy. Therefore, careful attention should be paid to making an accurate diagnosis and new strategies for more effective treatment, including chemotherapy, must to be developed in order to achieve long term survival in older patients with osteosarcoma.

Keyword

Aged; Prognosis; Prognostic Factor; Osteosarcoma

MeSH Terms

Tibia/pathology/radiography
Survival Analysis
Prognosis
Osteosarcoma/blood/*pathology/therapy
Middle Aged
Male
Humans
Follow-Up Studies
Female
Bone Neoplasms/blood/*pathology/therapy
Alkaline Phosphatase/blood
Aged
Age Factors
Adult

Figure

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  Fig. 1 Anteroposterior radiography shows an osteolytic lesion without periosteal reaction of the proximal tibia. This lesion was misdiagnosed as a giant cell tumor before biopsy.

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  Fig. 2 Kaplan-Meier curve between old age and adolescents patients shows significant differences. Older patients had a poorer prognosis.

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