title: Periosteal osteosarcoma: a single-institution experience.
abstract: BACKGROUND
  Periosteal osteosarcoma is a rare variant of osteosarcoma. Wide surgical removal is the mainstay of treatment, but controversy remains about the role of chemotherapy. The objective of this study was to review and analyze the clinical and treatment-related factors that influence the survival of patients with periosteal osteosarcoma who received treatment in a single institution.
  
  
  METHODS
  Thirty-three patients with periosteal osteosarcoma (19 males and 14 females) with a median age of 16 years (range, ages 6-32 years) underwent surgery (32 patients) and received radiotherapy (1 patient). Chemotherapy was received according to different regimens for high-grade osteosarcoma by 14 patients who had grade 3 tumors.
  
  
  RESULTS
  The 10-year overall survival rate was 84%. The only patient who did not undergo surgery died of disease after 9 months; for the remaining 32 patients the 10-year disease-free survival rate was 65%. Survival was not influenced by the receipt of chemotherapy. The patients who received chemotherapy had a 10-year overall survival rate of 86%, and those who received only local treatment had an overall survival rate of 83% (P = .73).
  
  
  CONCLUSIONS
  The authors' experience indicated that the treatment of periosteal osteosarcoma requires only wide surgical removal of the tumor and that adjuvant chemotherapy does not improve survival.
authors.affiliation: Chemotherapy Section, Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: Marilena
authors.initials: M
authors.lastname: Cesari
authors.forename: Marco
authors.initials: M
authors.lastname: Alberghini
authors.forename: Daniel
authors.initials: D
authors.lastname: Vanel
authors.forename: Emanuela
authors.initials: E
authors.lastname: Palmerini
authors.forename: Eric L
authors.initials: EL
authors.lastname: Staals
authors.forename: Alessandra
authors.initials: A
authors.lastname: Longhi
authors.forename: Massimo
authors.initials: M
authors.lastname: Abate
authors.forename: Cristina
authors.initials: C
authors.lastname: Ferrari
authors.forename: Alba
authors.initials: A
authors.lastname: Balladelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrari
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D012516:Osteosarcoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D010521:Periosteum; D012008:Recurrence; D012189:Retrospective Studies