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ABSTRACT

CLINICAL OUTCOME, ONCOLOGICAL RESULT AND SURVIVAL RATE OF


OSTEOSARCOMA WITH LIMB SALVAGE SURGERY AND AMPUTATION IN
RSUD DR. SOETOMO SURABAYA

Ferdiansyah1,Mouli Edward2,M. Hardian Basuki2,Yunus A Bari2,Bayu Antara H3


1
Head of Musculoskeletal Tumour Division of Orthopaedic and Traumatology Department, Medical Faculty
Universitas Airlangga - RSUD Dr Soetomo Surabaya
2
Member of Musculoskeletal Tumour Division of Orthopaedic and Traumatology Department, Medical Faculty
Universitas Airlangga - RSUD Dr Soetomo Surabaya
3
Resident of Orthopaedic and Traumatology Department, Medical Faculty Universitas Airlangga - RSUD Dr
Soetomo Surabaya

Backgrounds: Osteosarcoma is a malignant tumour originating from non-hematopoietic


group with the highest incidence rate among primary bone tumour cases in RSUD Dr
Soetomo (2001-2016) as many as 116 cases. Nowadays, Limb Salvage Surgery (LSS) is
developed rapidly for patients with primary malignant sarcoma.

Methods: This study was a quantitative study with a retrospective cohort study design. The
identification of osteosarcoma characteristics and clinical outcomes from LSS and
amputation in patients was using the MSTS Score, oncological result, survival rate and
postoperative complications. This study also describing the factors affecting the prognosis of
osteosarcoma.

Results: Male patients (61,5%) were more frequent than female patients (38,5%). The total
oncologic result in osteosarcoma patients in this study was 6,4%. Local recurrence rate in the
LSS group was 1,3%, while the amputation group was 2,6%. There is no bimodal distribution
based on age in our hospital. The five years of survival rate in the LSS group was 29,7%,
compared to the amputation group was 18,8%. The functional test results based on the MSTS
score system in the LSS group (mean of 18,14) were higher than the amputation group (mean
of 9,18) significantly.

Discussion: The most important factor in determining the type of surgery is tumour size and
staging of cancer. The Causative of the biggest difference in the survival rate is by a poor
general condition, large tumour size, and completeness of chemotherapy. LSS patients have
the best survival rate among other group due to the tumours size that are less than 8 cm and
better general condition. The group of LSS patients in this study also received complete
chemotherapy and received more comprehensive management (chemotherapy and surgery)
compared to the group of patients who underwent amputation or chemotherapy-only.

Conclusion: LSS has clinical outcome (functional score) and life expectancy better than
amputation. Patients treated with amputation experience recurrences more often compared to
patients with LSS

Keywords: Osteosarcoma, Limb Salvage Surgery, Amputation, Survival Rate

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