Non-Metastatic Osteosarcoma of the Extremities in Children Aged 5 Years or Younger

Background. The occurrence of high-grade osteosarcoma is rare in children aged 5 years or younger and only limited series or case reports have been described Methods. The records of patients aged 5,ears or younger with non-metastatic high-grade osteosarcoma of the extremities treated with surgery and adjuvant or neo-adjuvant chemotherapy at Rizzoli Institute between 1972 and 1999 were retrospectively evaluated in relation to gender, primary tumor site, histological subtype, surgical treatment, chemotherapy-induced tumor necrosis, 5- and 10-year event-free survival (EFS), and rate of local recurrence Data were compared to patients aged 6-40 years entered with the same diagnosis and over the same time interval Results. Data from 20 patients were collected Comparing these data with those from 1,106 patients 6-40 years of age only two main differences resulted the younger group showed a higher rate for fibroblastic subtype (P < 0 01) and for amputation surgery (P < 0 01) Among the two groups, no statistical difference was observed for the 5-year EFS (60% vs 53 8%, P = 0 6) and 10-year EFS (60% vs 52 1%, P = 0 5) The rate of local recurrence was 5 0% and 5 4% Conclusions. These findings suggest that in non-metastatic osteosarcoma of the extremities outcome and clinical characteristics are similar among children 5 years of age or younger and older patients However, in the younger group we have observed a significant higher rate of fibroblastic subtype as well as a significant higher rate of mutilating surgery Pediatr Blood Cancer (C) 2010,55 652-654 0 2010 Wiley-Liss, Inc