Referral patterns, treatment and outcome of high-grade malignant bone sarcoma in Scandinavia--SSG Central Register 25 years' experience.
AIMS
The objectives of this study were to present changes in referral patterns, treatment and survival in patients with high-grade malignant bone sarcoma in Sweden and Norway based on data in the Scandinavian Sarcoma Group (SSG) Central Register.


METHOD
Data on 1,437 patients with diagnosis 1986-2010 was analyzed.


RESULTS
Osteosarcoma was the most frequentl diagnosis (45%), followed by Ewing sarcoma (21%) and chondrosarcoma (17%). Thirty-one percent of Swedish and 41% of Norwegian patients had tumors in the axial skeleton. Eighty-six percent of extremity tumors and 66% of axial tumors were referred to a sarcoma center prior to unplanned surgery or biopsy. During the past decade, limb salvage surgery has risen from under 50% to over 80%. Five-year overall survival in non-metastatic osteosarcoma was 70% for extremity tumors, and 35% for axial tumors. No improvement in osteosarcoma survival was observed during the last decade. Five-year survival in Ewing sarcoma improved from 50% to 69%.


CONCLUSION
Referral patterns in bone sarcomas have improved. However, greater efforts should be dedicated to improving referral of patients with possible tumors in the axial skeleton to multidisciplinary teams (MDTs). Overall survival of patients with high-grade malignant bone sarcomas in Sweden and Norway is in line with other reports.
['Zaikova|Olga|O|', 'Sundby Hall|Kirsten|K|', 'Styring|Emelie|E|', 'Eriksson|Mikael|M|', 'Trovik|Clement S|CS|', 'Bergh|Peter|P|', 'Bjerkehagen|Bodil|B|', 'Skorpil|Mikael|M|', 'Weedon-Fekjaer|Harald|H|', 'Bauer|Henrik C F|HC|']
D000293:Adolescent D000328:Adult D000368:Aged D001859:Bone Neoplasms D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009664:Norway D012017:Referral and Consultation D012042:Registries D012509:Sarcoma D013548:Sweden D013997:Time Factors D016896:Treatment Outcome D055815:Young Adult
referral pattern bone sarcoma SSG osteosarcoma Ewing sarcoma chondrosarcoma overall survival