survival rate and clinical outcome of the osteosarcoma patient from 2018 to 2023 in indonesia

Osteosarcoma, a highly malignant primary bone tumor characterized by mesenchymal cells producing bone or osteoid, remains a significant oncological burden in indonesia. accurate assessment of survival and clinical outcomes is essential to inform treatment strategies and optimize patient care. this retrospective study analyzed long-term clinical outcomes of osteosarcoma patients treated at dr. soetomo general hospital between january 2018 and december 2023. inclusion criteria comprised histopathologically confirmed osteosarcoma and a minimum of one year of postoperative follow-up. functional status was evaluated using the musculoskeletal tumor society (msts) scoring system and karnofsky performance status. survival analysis was conducted using kaplan-meier curves, and subgroup comparisons were made based on surgical intervention (limb salvage, amputation, or no surgery), chemotherapy use (neoadjuvant/adjuvant), and metastasis presence. a total of 175 patients were included. the median overall survival (os) was 4 months (95% ci: 2.89–5.11), while event-free survival (efs) varied: limb salvage surgery (7 months, 95% ci: 3.14–10.86), amputation (4 months, 95% ci: 2.98–5.02), and no surgery (6 months, 95% ci: 0.16–11.84). although limb salvage surgery and neoadjuvant chemotherapy were associated with slightly improved outcomes, the differences were not statistically significant. overall, os and efs remain considerably lower than global averages. these findings highlight critical gaps in early diagnosis, standardized multimodal treatment availability, and long-term patient monitoring. enhancing access to comprehensive oncologic care tailored to the indonesian healthcare system is essential to improve survival and functional outcomes for osteosarcoma patients.