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Pediatric Osteosarcoma of Extremities

A 15-year Experience From a Tertiary Care Cancer Center in Upper Egypt

Morsy, Ahmed M. MD*; Abdelgawad, Marwa I. MD†,‡; Ahmed, Badawy M. MD§; Rezk, Khalid M. MD§; Aboelgheit, Amir M. MD; Ramadan, Islam K.-A. MD; Kamel, Hosam E.M. MD#; Fouad, Doaa M. MD#; Herdan, Rania A. MD**; Shabaan, Shimaa H. MD**; Eltyb, Hanan A. MD††

Journal of Pediatric Hematology/Oncology: August 2019 - Volume 41 - Issue 6 - p e371–e383
doi: 10.1097/MPH.0000000000001407
Online Articles: Original Articles

Aim: To assess the outcome and determine predictors of survival in pediatric patients with osteosarcoma of the extremities treated with a unified chemotherapy protocol at a single institution over a 15-year period.

Materials and Methods: We performed a retrospective analysis of medical records of 48 pediatric patients with histologically verified osteosarcoma of the extremities diagnosed at South Egypt Cancer Institute and received treatment between January 2001 and December 2015.

Results: With a median follow-up of 61 months for the entire cohort, estimates of overall survival (OS) for 3- and 5-year were 50.9% and 42.1%, respectively. While the estimates of OS for 3- and 5-year in the nonmetastatic group were 79% and 65.2%, respectively. In the multivariable analysis, both metastatic disease at diagnosis and poor response to chemotherapy retained their statistical significance as independent predictors for event-free survival. Whereas for OS, a metastatic disease at diagnosis remained as the lone predictor of a dismal outcome, while a poor response to chemotherapy became marginally associated with an inferior outcome.

Conclusions: In Upper Egypt, whereas slightly less than two thirds of children with localized osteosarcoma of extremities survives their disease, metastasis at presentation remains the key predictor of dismal survival outcomes.

Departments of *Pediatric Oncology

§Surgical Oncology



††Medical Oncology, South Egypt Cancer Institute, Assiut University

Departments of Clinical Oncology and Nuclear Medicine


Orthopedic Surgery and Traumatology, Faculty of Medicine, Assiut University, Assiut, Egypt

Department of Medical Oncology, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia

The authors declare no conflict of interest.

Reprints: Ahmed M. Morsy, MD, Pediatric Oncology Department, South Egypt Cancer Institute, El-methak Street, Assiut 71515, Egypt (e-mail:

Received October 15, 2018

Accepted December 9, 2018

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