Osteosarcoma in pre-adolescents: diagnostic interval, metastasis frequency, and treatment abandonment

Ricardo Gómez-Martínez, Department of Oncology, Unidad Médica de Alta Especialidad, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social; Department of Growth and Child Development Clinics, Human Reproduction, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara. Guadalajara, Jalisco, México
Miguel Á. Verdugo-Robles, Department of Oncology, Unidad Médica de Alta Especialidad, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco. México
Graciela López-Márquez, Department of Oncology, Unidad Médica de Alta Especialidad, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco. México
Aldo I. Santiago-Aguilar, Department of Oncology, Unidad Médica de Alta Especialidad, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco. México
Hugo Romo-Rubio, Department of Oncology, Unidad Médica de Alta Especialidad, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco. México

Background: osteosarcoma is the most common malignant bone tumor, but it is rare before adolescence. The clinical behavior of the tumor that develops in pre-adolescents may differ from that seen during adolescence. Method: This is a retrospective study of pre-adolescents with osteosarcoma diagnosed in a tertiary-level hospital. The patients were compared with adolescents diagnosed during the same period. Results: we analyzed 149 patients (forty-four pre-adolescents). The diagnostic interval median was 7 weeks in pre-adolescents and 12 weeks in adolescents (p = 0.002). Forty-four patients had metastases at diagnosis (ten pre-adolescents) (p = 0.23). Limb-salvage surgery was performed on sixteen patients (two pre-adolescents). Fifty-six patients (thirteen pre-adolescents) abandoned the treatment (p = 0.18). Overall survival was 63 months in pre-adolescents and 52 months in adolescents (p = 0.301). Conclusion: We only found differences in the diagnostic interval, which was shorter in pre-adolescent patients. Studies with a larger number of pre-adolescents are necessary to determine the differences in the characteristics of the disease in adolescent patients.

Keywords: Osteosarcoma. Metastases. Pre-adolescents. Treatment abandonment. Survival.