Long-Term Clinical Outcome and Survivorship Issues of High Grade Bone Sarcomas

We performed a retrospective review of 70 cases of high-grade bone sarcomas treated at the Institute Jules Bordet (IJB) between 2000 and 2008. Eighty nine percent of patients underwent surgery, 74% chemotherapy, and 26% radiotherapy with curative intent. The five-year overall survival rate was 60% (osteosarcoma and Ewing’s sarcoma: 55%; chondrosarcoma: 85%). The disease-free survival rates at five years were 64% (osteosarcoma: 50%; Ewing’s sarcoma and chondrosarcoma: 78%). One toxic death and one post-operative death occurred. We could identify the following 5-year side effect rates (without the unknowns): Infertility 92%, cardiovascular disorders 18%, hypercholesterolemia 41%, hypertriglyceridemia 10%, renal failure 11%, functional disorders 50%, osteoporosis 16%, and chronic pain 26%. The clinical outcome of our patients compares favourably with the literature. Because the majority of patients are very young, quality of life issues is important for survivors. However, evaluating survivorship issues will remains inaccurate unless follow-up is standardized, with specials fields designated in the medical chart. This study emphasizes the need for rigorous systematization of the follow-up parameters used in medical charts in order to better identify survivors’ needs.