To investigate the clinical features and therapeutic effect of osteosarcoma in elderly patients (older than 60 years).

Ten cases of osteosarcoma older than 60 years in Qilu Hospital of Shandong University from January 2007 to March 2017 were analyzed retrospectively. There were eight females and two males, with a mean age of 66±6 years (range: 60-75 years). The tumor occurred at femur in five cases, one case at soft tissue of ankle, one case at multiple sites, pelvis in one case, humerus in one case and astragalus in one case. Among the ten cases, two cases received amputation, two cases received amputation and chemotherapy, one case received wide resection, three cases received wide resection and chemotherapy, one case received marginal resection and radiotherapy and one case only received chemotherapy.

The duration from presentation was more than 6 months in four cases. Two cases had lung metastasis before diagnosis. In addition, five cases had comorbidity and the level of ALP in serum was high (>125 U/L) in two cases. Based on imaging examination, seven cases showed a mixture of osteosclerotic and osteolytic lesions, one case showed osteolytic lesion, one case showed osteosclerotic lesion and one case had soft tissue lesion. Histologically, there were seven cases of conventional osteosarcoma, two cases of parosteal osteosarcoma and one case of well-differentiated intraosseouso steosarcoma. Ten cases were followed up for an average period of 40±37 months (range: 3.5-124 months). One case with lung metastasis only received chemotherapy died 3.5 months after diagnosis. One case with lung metastasis treated with radiofrequency ablation survived 58 months after diagnosis. One case underwent amputation after recurrence in astragalus. There was no recurrence or metastasis in the other seven patients.

Osteosarcoma in elderly patients is rare and distinct from osteosarcoma in adolescents in term of clinical features and prognosis. It should be early diagnosed and appropriately treated to decrease the rate of recurrence and metastasis and to improve the overall survival.