Retrospective cohort of 355 high-grade osteosarcoma patients from the Rizzoli Institute examining which factors predict local recurrence — asking whether chemotherapy response, surgical margins, patient age, sex, diagnosis date, and tumor site independently influence local control.
When planning limb salvage for osteosarcoma, the combination of final histologic necrosis grade and margin quality should frame your recurrence counseling: a good responder with wide margins has ~1% recurrence risk, but any patient with less-than-good necrosis and less-than-wide margins faces a 17–46× higher risk — a threshold that may justify early secondary amputation before local failure occurs.
Pay particular attention to the popliteal space, intramedullary canal, and biopsy tract as the highest-yield sites for margin failure.
Retrospective cohort of 355 high-grade osteosarcoma patients from the Rizzoli Institute examining which factors predict local recurrence — asking whether chemotherapy response, surgical margins, patient age, sex, diagnosis date, and tumor site independently influence local control.
When planning limb salvage for osteosarcoma, the combination of final histologic necrosis grade and margin quality should frame your recurrence counseling: a good responder with wide margins has ~1% recurrence risk, but any patient with less-than-good necrosis and less-than-wide margins faces a 17–46× higher risk — a threshold that may justify early secondary amputation before local failure occurs.
Pay particular attention to the popliteal space, intramedullary canal, and biopsy tract as the highest-yield sites for margin failure.