Comparison of Outcome Between Neoadjuvant Chemotherapy with Limb Salvage Surgery and Amputation with Chemotherapy in Osteosarcoma Patients: A Systematic Review
Abstract
Introduction: Osteosarcoma is a rare malignant bone tumour arising from primitive mesenchymal tissue, most often affecting males aged 10–30. Historically, treatment involved amputation or disarticulation, with a 5-year overall survival rate of just 20%.
Materials and methods: This systematic review included studies from MEDLINE, Cochrane, EMBASE, and Google Scholar. Additionally, reference lists of relevant sources were manually reviewed. The search, conducted through 2021, used terms such as amputation, osteosarcoma, bone cancer, recurrence, and metastasis.
Results: Eight relevant studies were thoroughly reviewed, most conducted at single institutions and published between 1990 and 2019, covering data from 1983 to 2015 and involving 1,389 patients. Three studies (646 patients) assessed 5-year disease-free survival (DFS) in limb osteosarcoma, reporting a median DFS of 56.9 months (range: 6–78 months). Five studies (969 patients) analysed local recurrence, showing higher relapse rates with limb salvage surgery (LSS) compared to amputation (73.5% vs. 28.1%). Additionally, six studies (1,141 patients) evaluated 5-year overall survival, with better outcomes in the LSS group (351 survivors) compared to the amputation group (248 survivors).
Conclusion: In conclusion, this thorough review makes a valuable contribution to the current understanding of survival and local recurrence outcomes in patients with limb osteosarcoma treated with either LSS or amputation. The findings suggest that LSS is associated with a higher 5-yearsurvival rate compared to amputation.
Abstract | Reference
