Epidemiology of Malignant Bone Tumors in a Tertiary Care Hospital of the Himalayan Region of India: a Review of 97 Cases

Abstract

Bone tumors remain a difficult challenge for orthopedic surgeons to date. This challenge is heightened in developing countries like India due to limited diagnostic and therapeutic facilities as well as due to ignorance of patients. A specialty clinic was started with this intention. We describe the early experience of our bone tumor clinic. The purpose of this study is to determine the pattern of malignant bone tumors including their relative frequencies, age, and sex distribution, anatomical sites of occurrence, and clinicopathological characteristics as seen in a newly established tertiary care hospital in India, and to compare our data with the available date of India and other countries. This data could be potentially useful to plan management and provide a perspective for developing advanced facilities in the future. A retrospective review was performed for all the histopathological confirmed cases of malignant bone tumors seen in the initial 2 years of the bone tumor specialty clinic. An audit was done with the available resources and our data was compared with other available literature. Ninety-seven cases of malignant bone tumors were reported, the peak age of incidence of primary and metastatic bone tumors was in the age group of 11–20 years (37.5%) and 51–60 years (35.7%), respectively. Osteosarcoma accounted for 26.08% of all the primary malignant tumors in the study. The femur was the most common site for primary malignant bone tumors and accounted for 22 cases out of 48 cases (45.8%) and the spine was the most common site for secondaries accounted for 15 cases (53.57%) followed by the femur which accounted for 10 cases (35.7%) out of 28 patients of metastatic bone disease. Primary malignant bone tumors occur mainly in the second decade of life with a male preponderance. Osteosarcoma is the most common followed by Ewing sarcoma which is in line with other available literature. In our study, the most common primary foci for metastatic bone tumors are from the lungs followed by the thyroid and the most common site for metastasis in bones is the spine followed by the femur.