title: Extraskeletal osteosarcoma of the hand: the role of marginal excision and adjuvant radiation therapy.
abstract: BACKGROUND
  Extraskeletal osteosarcoma of the hand is rare, and its optimal modality of local control is not currently known.
  
  
  METHODS
  A literature search was performed to identify studies that describe the treatment and outcomes of extraskeletal osteosarcoma. A second literature search was performed to identify studies that describe the treatment and outcomes of extraskeletal osteosarcoma of the hand specifically.
  
  
  RESULTS
  The role of adjuvant radiation for extraskeletal osteosarcoma is not well defined. All cases in the literature describing treatment of extraskeletal osteosarcoma of the hand utilized amputation, and none of the patients described received radiation therapy. However, there are multiple reports showing excellent local control, minimal toxicity, and superior functional outcome with limb conservation and radiation rather than amputation of the hand in pediatric and adult soft tissue sarcoma.
  
  
  CONCLUSIONS
  For extraskeletal osteosarcoma of the hand, we recommend a treatment approach with the goal of preservation of form and function using limb-sparing surgery and planned postoperative radiation.
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA USA.
authors.forename: Dana L
authors.initials: DL
authors.lastname: Casey
authors.affiliation: Department of Pathology, Stanford University, Stanford, CA USA.
authors.forename: Matt
authors.initials: M
authors.lastname: van de Rijn
authors.affiliation: Department of Radiology, Stanford University, Stanford, CA USA.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Riley
authors.affiliation: Department of Radiology, Stanford University, Stanford, CA USA.
authors.forename: Ka-Wah
authors.initials: KW
authors.lastname: Tung
authors.affiliation: Department of Surgery, Stanford University, Stanford, CA USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Mohler
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA USA ; Department of Radiation Oncology, Stanford University Cancer Center, 875 Blake Wilbur Drive, Stanford, CA 94305 USA.
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Donaldson
keywords: Hand; Limb salvage; Osteosarcoma; Radiation therapy; Soft tissue sarcoma