Osteosarcoma in the elderly: Clinical features and outcome

Abstract

Osteosarcoma developing in elderly persons has several characteristic features. A predilection for the axial skeleton, particularly the pelvis, has been noted. Secondary osteosarcoma due to preexisting conditions such as irradiated bone, Paget’s disease, fibrous dysplasia, and bone infarct is occasionally observed in the elderly. Because osteosarcoma is relatively rare in the aged persons, diagnostic delay is common, with this exerting a possibly adverse effect on prognosis. Treatment-related factors also may affect the prognosis of elderly patients with osteosarcoma. Difficulty in achieving wide resection is reported because axial bones are affected in a high proportion of elderly osteosarcoma patients. Tolerability and completion rate of chemotherapy are lower in the elderly as compared with younger patients. In this chapter, tumor-related features and treatment-related characteristics are described in elderly patients with osteosarcoma.