Objective To analyze the clinical efficacy of treatment of aged 40-60 patients with osteosarcoma, summarize the prognostic factors and discuss the treatment strategy. Methods A retrospective analysis was made on 62 patients aged 40 to 60 who were diagnosed as limb osteosarcoma in 7 osteosarcoma treatment centers in China from April 2002 to October 2015. There were 34 males and 28 females. The age range was limited to 40-60 years, with an average age of 50.4 years. The data about general information, site of onset, preoperative puncture, chemotherapy, surgical methods, recurrence, metastasis and survival, and corresponding follow-up of patients were collected. Using the above factors as variables, Kaplan-meier method was used to calculate the survival rate, and the relationship between these factors and the 3- and 5-year survival rate was studied. Results The lesions occurred around the knee joint in 50 cases among 62 patients, accounting for 80.6%. All 62 patients with osteosarcoma of extremities were followed up for 12-115 months, with an average follow-up time of 43 months. The overall 3- and 5-year survival rate was 80.6% and 56.5% respectively. The 3- and 5-year disease-free survival rate was 41.9% and 32.3% respectively. The 5-year overall survival rate was 52.1% and 62.1% in preoperative chemotherapy group and non-chemotherapy group, 52.1% and 71.4% in postoperative chemotherapy group and non-chemotherapy group, 51.6% and 61.3% in preoperative and post-operative chemotherapy group and non-chemotherapy group, 57.1% and 53.8% in limb salvage operation group and amputation operation group, respectively. The 3-year survival rate postoperation in patients without recurrence or metastasis, simple recurrence, pulmonary metastasis or multiple metastasis was 89.7%, 78.6%, 50.0% and 73.3% respectively. Conclusion The incidence of osteosarcoma around knee joint is higher and the prognosis is worse in 40-60 years old patients than in younger patients. The prognosis is closely related to the definite diagnosis of preoperative puncture and the recurrence and metastasis after operation. The clinical treatment of osteosarcoma in limbs aged 40 to 60 should be based on full resection of tumors, strictly following Enneking surgical staging, and reducing the recurrence and metastasis rate of tumors in order to improve the prognosis. |