Posters— Surgical Treatment of Sarcomas

OUTCOME FOLLOWING LOCAL RECURRENCE IN OSTEOSARCOMA

AUTHOR: R J Grimer FROM: The Royal Orthopaedic Hospital Oncology Service, Bristol Road South, Birmingham, U.K.

Purpose: Local recurrence of Osteosarcoma is generally thought to be a death sentence with few patients surviving. This paper addresses this question and attempts to identify possible prognostic factors and treatment options for patients with local recurrence.

Method: All patients who had developed a local recurrence following treatment of a non-metastatic high grade osteosarcoma were included in this review. Patients with metastases at the time of diagnosis were excluded. 81 patients were found to fulfill the above criteria. LR arose at an average of 16 months (range 3 to 49 months). 16 of the patients were already known to have lung metastases and a further 27 were found to have metastatses within 3 months of treatment of the LR. Another 25 developed metastases later, leaving only 8 patients who did NOT subsequently develop metastases.

Results: Overall survival was most clearly related to whether or not metastases were present at the time of presentation with LR. In patients with known metastases or ones which appeared within 3 months there were no survivors past 30 months. For those with no metastases within 3 months the survival was 40% at 5 years from the time of LR. Even in those 25 who developed metastases later the survival was 30% at 3 years and 23% at 5 years. Disease free interval was not significant.

Conclusion: LR accompanied by metastases is currently a death sentence. Experimental treatments for these patients may be justified. In patients with solitary LR aggressive treatment is justified and has a similar outlook to that for lung metastases alone.