Primary malignant bone tumours: Epidemiological data from an Orthopaedic Oncology Unit in South Africa

Abstract

Introduction: Limited data is available with regard to the epidemiology of primary malignant orthopaedic tumours in the South African clinical setting. As a result, orthopaedic surgeons have to rely on data from other countries when formulating differential diagnoses for malignant bone lesions. Existing data, however, demonstrates variance in the incidence between different geographic regions. By analysing the tumour epidemiology at our centre and comparing it to published data from other parts of the world, we aim to better define the local prevalence of primary malignant bone tumours. Materials and methods: A retrospective review of all patients with biopsy confirmed malignant primary bone tumours that presented between January 2008 and June 2015 were conducted. Patients with multiple myeloma and lymphoma were excluded. Epidemiological data pertaining to patient demographics, tumour location and histological diagnosis were recorded and analysed. Results: Included for review were 117 patients with biopsy-confirmed primary malignant bone tumours. Tumours involving the proximal humerus, distal femur, proximal tibia and pelvis accounted for 80% of all tumours. Osteosarcoma was the most common histological diagnosis (72.6%) and higher than reported figures from any other country. It was followed by chondrosarcoma (11.4%), Ewing's sarcoma (9.4%), spindle cell sarcoma (4.2%) and malignant giant cell tumour (GCT) (1.7%). A single patient was diagnosed with adamantinoma. HIV infection had no significant association with primary bone tumour incidence. Conclusion: Epidemiological data from this review reflect small but significant differences compared to international literature. The incidence of osteosarcoma appeared to be higher than in previous reports from other regions. Future study in this area may identify a reason for this difference, socioeconomic reasons may be responsible.

Epidemiology and Risk Factors of Osteosarcoma

“…In the analysis of 117 patients with primary bone tumors, Pillay et al revealed that osteosarcoma was the most common primary malignant bone tumor, accounting for 72.6% of all cases admitted to the Department of Orthopaedic Surgery, Grey's Hospital, South Africa (52). In accordance with findings reported in previous studies, the authors also confirmed the higher male to female ratio and younger age of patients, (4,28,53,54).…”

The prevalence of vascular injury utilising the lateral parapatellar approach for malignant distal femoral tumour resections: a case series

“…This is in keeping with findings in the literature, which shows a higher prevalence of osteosarcoma in the second decade of life. 11 Results in this series did not reflect a bimodal distribution. Contrary to the literature, which shows a slight male predominance, this series had a slight female-to-male predominance ratio of 1.1:1.…”

“…Distal femoral tumours predominantly consist of osteosarcoma, chondrosarcoma and Ewing's sarcoma. 11,12 Neo-adjuvant chemotherapy, surgical resection with a wide margin and adjuvant chemotherapy is considered to be the mainstay of treatment of osteosarcoma and Ewing's sarcoma. 13 Reconstructive options have evolved significantly and differ for various age groups.…”

“…Contrary to the literature, which shows a slight male predominance, this series had a slight female-to-male predominance ratio of 1.1:1. 4,11,14 Telangiectatic osteosarcoma represents 3-10% of all osteosarcoma. 15 The age distribution for this subtype of osteosarcoma tends to be younger than conventional osteosarcoma.…”

Genetic alterations and diagnosis in Ewing sarcoma: A review

“…ES is the second most frequent primary skeletal tumor, only after osteosarcoma, and it has the most unfavorable prognosis. It is considered very aggressive and very rare, accounting with 0.2% of all cancers and 2.9% of the entire childhood one [2,10,11]. It has an annual incidence of 3: 1.000.000, affecting mainly children, adolescents and young adults, with a peak in the second decade of life [8,9,11,12].…”