Functional And Survival Outcome Of Egyptian Children And Adolescents With Malignant Bone Tumors: An Experience In A Setting Of Limited Health Resource

Abstract

Abstract Objective Evaluate outcome of paediatric malignant bone tumours at Ain Shams University, Egypt, from January 2003 to July 2016. Methods Retrospective data analysis regarding clinico-epidemiological aspects, treatment outcomes, survival analysis and musculoskeletal tumour society score (MSTS score). Results The study included 37 patients; 22 had Ewing sarcoma (ES) and 15 had osteosarcoma, male: female ratio 0.85:1, median ages of 11. The overall frequency was 2.3% among all cancers. There is wide range of time lag until diagnosis. Patients with ES were significantly younger than those with osteosarcoma were. Swelling was the most common presenting symptom and femur was the most common affected site. Fifteen patients fulfilled MSTS criteria; most of them had excellent MSTS score, which significantly affected by type of surgery. ES patients were treated with POG#9354/CCG#7942 protocols and osteosarcoma with CCG#7921 protocol. Limb salvage was the most common type for surgical local control. Most common cause of death was relapse, whereas infection was the most common complication of treatment. 1-year, 2-year, 3-year overall-survival of osteosarcoma were 93.3%, 40%, and 13.3% respectively and 77.3%, 40.9%, and 18.2% respectively for ES. 1-year, 2-year, 3-year event-free-survival were 80%, 40%, and 13.3% respectively and 72.7%, 22.7%, and 18.2% respectively for ES patients. Conclusion Although survival rates for malignant bone tumours are still unsatisfactory, the functional outcome of extremity tumours after limb salvage procedures is promising