Treatment Outcome of Pelvic Osteosarcoma a 20 Year Experience in a Single Institution

Abstract

Purpose: Osteosarcoma of limbs shows excellent therapeutic results due to development of diagnostic and treatment methods. However, osteosarcoma of pelvic bone is known to have lower incidence than those of limbs and poorer prognosis. This study is performed to research the diagnosis, treatment, treatment outcomes, and complications of osteosarcoma of pelvic bone and propose standards for adequate treatment. Objective and Method: 16 cases that were diagnosed as osteosarcoma of pelvic bone from January 1988 to October 2010 in Kosin University Gospel Hospital were analyzed. Follow-up periods were at least 2 months up to 60 months. There were 6 cases of male and 10 cases of female, and mean age was 44.3 (14 ~ 74) years old. 5 cases were accompanied by pulmonary metastasis at the time of the diagnosis. Surgical treatment including preoperative and postoperative chemotherapy was performed in 9 cases, and only chemotherapy and radiation were performed in 1 case. Among 9 cases having undergone surgical treatment, 3 cases were performed with biological reconstruction using autogenous bone graft and total hip replacement together, 1 case was performed with extracorporeal irradiated recycled autogenous bone graft, 1 case was performed with reconstruction using tumor prosthesis, and 4 cases were performed with wide excision. Retrospective review was done about diagnostic procedures, treatment methods and results, and complications. Results: Mean period from the onset of symptoms to the time of the diagnosis was 6.3 (3 ~ 12) months, and the symptoms were 7 cases of hip pain, each 3 cases of lumbar pain and radiating pain to lower limbs, pelvic mass, each 2 cases of inguinal pain, and each 1 case of thigh pain, Among the 9 cases performed with preoperative and postoperative chemotherapy and surgical treatment, there were 6 cases of T-10 protocol, 2 cases of T-20 protocol, and 1 case of IA (Intraarterial) Cis protocol. In the 1 case that haven’t undergone surgical treatment, T-10 protocol was performed. 13 of the 16 cases were expired, with the mean time of 15 (2 ~ 47 months) from the time of the diagnosis to death. Complications were 4 cases of surgical infection, and 1 case of peroneal nerve palsy. Conclusion: Osteosarcoma occurred in the pelvic bone may delay the start of the diagnosis and treatment, and prognosis is too bad. Early diagnosis is important, and this purpose, high-resolution and precise imaging tests performed with tumorrelated blood tests is necessary. In addition, preoperative systemic chemotherapy, rather than intra-aterial chemotherapy is recommended.