title: A meta-analysis of osteosarcoma outcomes in the modern medical era.
abstract: Four decades ago, specialized chemotherapy regimens turned osteosarcoma, once considered a uniformly fatal disease, into a disease in which a majority of patients survive. Though significant survival gains were made from the 1960s to the 1980s, further outcome improvements appear to have plateaued. This study aims to comprehensively review all significant, published data regarding osteosarcoma and outcome in the modern medical era in order to gauge treatment progress. Our results indicate that published survival improved dramatically from 1960s to 1980s and then leveled, or in some measures decreased. Recurrence rates decreased in the 1970s and then leveled. In contrast, published limb salvage rates have increased significantly every recent decade until the present. Though significant gains have been made in the past, no improvement in published osteosarcoma survival has been seen since 1980, highlighting the importance of a new strategy in the systemic management of this still very lethal condition.
authors.affiliation: Division of Orthopedic Oncology, Department of Orthopedic Surgery, Keck School of Medicine, Los Angeles County Medical Center, University of Southern California, 1520 San Pablo Street, Suite 2000, Los Angeles, CA 90033, USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Allison
authors.forename: Scott C
authors.initials: SC
authors.lastname: Carney
authors.forename: Elke R
authors.initials: ER
authors.lastname: Ahlmann
authors.forename: Andrew
authors.initials: A
authors.lastname: Hendifar
authors.forename: Sant
authors.initials: S
authors.lastname: Chawla
authors.forename: Alex
authors.initials: A
authors.lastname: Fedenko
authors.forename: Constance
authors.initials: C
authors.lastname: Angeles
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Menendez