title: Synchronous multifocal osteosarcoma: results in twelve patients treated with neoadjuvant chemotherapy and simultaneous resection of all involved bones.
abstract: BACKGROUND
  Multifocal osteosarcoma is a rare type of tumor which is always excluded from therapy trials and is therefore rarely investigated for prognosis and treatment.
  
  
  METHODS
  Twelve patients with synchronous multifocal osteosarcoma underwent neoadjuvant chemotherapy and, when feasible, simultaneous resection of involved bones.
  
  
  RESULTS
  Four patients were unsuitable for resection and died 5-13 months (average 9 months) later. In eight patients all lesions were resected simultaneously. Four patients are disease-free at 15, 20, 24, and 60 months (average 29 months), and four relapsed and died at 12, 24, 30 and 36 months (average 30.5 months).
  
  
  CONCLUSIONS
  Chemotherapy associated with aggressive surgery may be useful. The histological response of different lesions in the same patient are strongly correlated, confirming that synchronous multifocal osteosarcoma is not originally multicentric but unicentric with bone metastases.
authors.affiliation: Sezione di Chemioterapia, Istituti Ortopedici Rizzoli, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bacci
authors.forename: P
authors.initials: P
authors.lastname: Picci
authors.forename: S
authors.initials: S
authors.lastname: Ferrari
authors.forename: M
authors.initials: M
authors.lastname: Mercuri
authors.forename: A
authors.initials: A
authors.lastname: Briccoli
authors.forename: D
authors.initials: D
authors.lastname: Donati
authors.forename: M
authors.initials: M
authors.lastname: Manfrini
authors.forename: A
authors.initials: A
authors.lastname: Zanoni
authors.forename: C
authors.initials: C
authors.lastname: Forni
authors.forename: M
authors.initials: M
authors.lastname: Campanacci
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D012516:Osteosarcoma / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome