Background: Osteosarcoma is the most common bone cancer in children, responsible for a high rate of
amputation and death. This is the first long-term, population-based, epidemiologic and survival study in
Thailand. Objective: To study the incidence and survival rates of pediatric osteosarcoma in Khon Kaen.
Method: Childhood osteosarcoma cases (0-19 years) diagnosed between 1985-2010 were reviewed. The data
were retrieved from the population-based data set of the Khon Kaen Cancer Registry and medical records
from Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. All cases were censored until the end
of April 2012. The age-standardized incidence rate (ASR) was calculated using the standard method. Survival
experience was analyzed using the standard survival function (STATA 9.0) and presented with a Kaplan-Meier
curve. Results: 58 cases were enrolled. The overall ASR was 14.1 per million. Males and females were equally
affected. The peak incidence was for 15-19 year-olds in both sexes (ASR=10.4 per million in males and 8.5 in
females). The 5-year overall survival rate was 27.6% (95% CI: 15.8-40.8%). The median survival time was 1.6
years (95% CI: 1.2-2.1). In a subgroup analysis, the patients who received only chemotherapy survived longer
(5-year survival 45.7%, median survival time 4.1 years, p=0.12). Conclusion: The incidence rate for childhood
osteosarcoma was slightly less than those reported for Western countries. The survival rate was also lower than
reports from developed countries. Further evaluation of the treatment protocol and risk factor stratification is
needed.