title: Management and outcome after local recurrence of osteosarcoma.
abstract: We report on the management and outcome of 96 patients who developed local recurrence (LR) after having definitive primary treatment with chemotherapy and surgery for non-metastatic osteosarcoma. LR developed at a median of 11 months from initial surgical treatment. 18% of patients had metastases prior to the diagnosis of LR and 23% were found to have metastases synchronously. The prognosis for this group with metastases was 14% survival at 2 years. In the 57 patients without metastases at the time of development of LR, survival was 51% at 2 years and 41% at 5 years. Treatment was by excision of the LR and radiotherapy or by amputation. The only significant prognostic factors identified were the presence of metastases at the time of development of LR (P < 0.0001) and small size of the LR. The role of adjuvant chemotherapy was unclear. Whilst every attempt should be made to avoid LR, patients who develop LR are curable, particularly if they do not have metastases at the time of diagnosis of the LR.
authors.affiliation: The Royal Orthopaedic Hospital Oncology Service, Royal Orthopaedioc Hospital, Bristol Road South Northfield, Birmingham B31 2AP, UK. rob.grimer@roh.nhs.uk
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Grimer
authors.forename: Scott
authors.initials: S
authors.lastname: Sommerville
authors.forename: David
authors.initials: D
authors.lastname: Warnock
authors.forename: Simon
authors.initials: S
authors.lastname: Carter
authors.forename: Roger
authors.initials: R
authors.lastname: Tillman
authors.forename: Adesegun
authors.initials: A
authors.lastname: Abudu
authors.forename: David
authors.initials: D
authors.lastname: Spooner
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012516:Osteosarcoma / Q000601:surgery*; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome