NON METASTATIC OSTEOSARCOMA. EXPERIENCE AT SKMCH & RC ALIA ZAIDI, AHSAN SHAMIM, WASILA SHAMIM SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE

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<ul><li>Slide 1</li></ul> <p>NON METASTATIC OSTEOSARCOMA. EXPERIENCE AT SKMCH &amp; RC ALIA ZAIDI, AHSAN SHAMIM, WASILA SHAMIM SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE Slide 2 Slide 3 Slide 4 NON METASTATIC OSTEOSARCOMA. EXPERIENCE AT SKMCH &amp; RC ALIA ZAIDI, AHSAN SHAMIM, WASILA SHAMIM SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE Slide 5 BACKGROUND THE ROLE OF CHEMOTHERAPY IN THE TREATMENT OF OSTEOSARCOMA IS NOW WELL ESTABLISHED. THE ROLE OF CHEMOTHERAPY IN THE TREATMENT OF OSTEOSARCOMA IS NOW WELL ESTABLISHED. MOST CENTRES REPORT AN EFS &gt; 60% AND OS &gt;70% FOR NON-METASTATIC, EXTREMITY OSTEOSARCOMA. MOST CENTRES REPORT AN EFS &gt; 60% AND OS &gt;70% FOR NON-METASTATIC, EXTREMITY OSTEOSARCOMA. THE PURPOSE OF THIS STUDY WAS TO ANALYZE TREATMENT OUTCOME FOR OSTEOSARCOMA AT OUR HOSPITAL. THE PURPOSE OF THIS STUDY WAS TO ANALYZE TREATMENT OUTCOME FOR OSTEOSARCOMA AT OUR HOSPITAL. BETWEEN DECEMBER1994 AND APRIL 2004, 278 PATIENTS 12 years age &amp; 12gm/M2 for 12 years age &amp; 12gm/M2 for EFS ACCORDING TO THERAPY RELATED VARIABLES %age Necrosis 90% = 19 (P=0.8633) Slide 31 EFS ACCORDING TO THERAPY RELATED VARIABLES Amputation Vs Limb Salvage Limb salvage=19 Amputation = 44 (P =0.1895) Slide 32 RESULTS SUMMARY OVERALL SURVIVAL 60.4% AT 5YRS. EVENT FREE SURVIVAL 40% AT 5YRS. NO OS DIFFERENCE BETWEEN GOOD AND BAD RESPONDERS TO INITIAL CHEMOTHERAPY. NO OS DIFFERENCE BETWEEN LIMB SALVAGE AND ABLATION. TREATMENT WAS GENERALLY WELL TOLERATED. Slide 33 Literature Review Sr. no JournalAuthor Pat. No. F/upEFS%OS% 1 Ann of Oncol 8:765-771,1997 Ferrari et al 127 12 yrs 46%53% 2 Clin Ortho &amp; Related Research 358:120-127,1999 Sluga et al 133 5 yrs 67%70% 3 J Clin Oncol 18:4016-4027, 2000 Bacci et al 164 5 yrs 63%75% 4 The Oncologist, 9:422-441, 2004. Marina et al Review article 5 yrs 10 yrs 74%71% Slide 34 DISCUSSION LATE PRESENTATION HIGH PERCENTAGE OF MACROMETASTASES AT PRESENTATION (35 OF 134 = 26%). HIGH PERCENTAGE OF MACROMETASTASES AT PRESENTATION (35 OF 134 = 26%). LARGE NUMBER PATIENTS PRESENTING WITH HUGE FUNGATING TUMOURS REQUIRING UPFRONT AMPUTATION. LARGE NUMBER PATIENTS PRESENTING WITH HUGE FUNGATING TUMOURS REQUIRING UPFRONT AMPUTATION. Slide 35 DISCUSSION LACK OF EDUCATION &amp; AWARENESS HIGH TENDENCY FOR FAMILIES TO DISCONTINUE TREATMENT MIDWAY. HIGH TENDENCY FOR FAMILIES TO DISCONTINUE TREATMENT MIDWAY. FAILURE TO CONTINUE REGULAR FOLLOW UP IF THE PATIENT IS ALRIGHT POST TREATMENT. FAILURE TO CONTINUE REGULAR FOLLOW UP IF THE PATIENT IS ALRIGHT POST TREATMENT. Slide 36 DISCUSSION HIGH SYSTEMIC INFECTION RATE AND CO- MORBIDITY 6 DEATHS (31.5%) WERE DUE TO INFECTIONS 6 DEATHS (31.5%) WERE DUE TO INFECTIONS HEPATITIS B WITH HEPATIC HEPATITIS B WITH HEPATIC ENCEPHALOPATHY = 4 ENCEPHALOPATHY = 4 SEPTIC SHOCK = 1 SEPTIC SHOCK = 1 FUNGAL PNEUMONIA = 1 FUNGAL PNEUMONIA = 1 Slide 37 DISCUSSION POSSIBILITY OF BIOLOGICALLY AGGRESSIVE DISEASE? 44 OF 63 (70%) HAD</p>