title: Efficacy of Pre- and Postoperative Chemotherapy in Patients with Osteosarcoma of the Extremities.
abstract: OBJECTIVE
  We evaluated the treatment efficacy including survival and recurrence, and factors associated with recurrence in osteosarcoma patients treated with preoperative chemotherapy, surgery, and adjuvant chemotherapy.
  
  
  METHODS
  Forty nine patients with osteosarcoma were treated with preoperative chemotherapy with intra-arterial cisplatin and adriamycin infusion for 3 cycles, followed by surgery. According to the pathologic response, if tumor was necrotized more than 90%, the same adjuvant chemotherapy was reintroduced for 3 cycles, and if the response was not enough, then the salvage regimen was introduced. Plain chest film and chest CT scan were taken monthly and every 3 months, respectively. When tumor recurred, the metastasectomy was performed whenever possible.
  
  
  RESULTS
  Forty three patients were evaluable with amedian follow up of 53 months. Five-year disease-free and overallsurvival rate was 47.0% and 66.9%, respectively. The recurrence was observed in 22 patients (51.2%) with median time of 12.5 months. Baseline alkaline phosphatase (ALP) was the only significant factor for recurrence (p=0.03) and the patients with the possibility of metastasectomy recurrence showed higher post-relapse survival compared to other treatment modalities (26 momths vs 5~12 months).
  
  
  CONCLUSIONS
  These results indicates that pre- and postoperative chemotherapy with intra-arterial cisplatin and adriamycin infusion showed comparable treatment efficacy and acceptable toxicities.
authors.forename: J H
authors.initials: JH
authors.lastname: Sohn
authors.forename: S Y
authors.initials: SY
authors.lastname: Rha
authors.forename: H C
authors.initials: HC
authors.lastname: Jeung
authors.forename: H J
authors.initials: HJ
authors.lastname: Shin
authors.forename: Y S
authors.initials: YS
authors.lastname: Goo
authors.forename: H C
authors.initials: HC
authors.lastname: Chung
authors.forename: W I
authors.initials: WI
authors.lastname: Yang
authors.forename: S B
authors.initials: SB
authors.lastname: Hahn
authors.forename: K H
authors.initials: KH
authors.lastname: Shin
authors.forename: J S
authors.initials: JS
authors.lastname: Min
authors.forename: B S
authors.initials: BS
authors.lastname: Kim
authors.forename: J K
authors.initials: JK
authors.lastname: Roh
authors.forename: W I
authors.initials: WI
authors.lastname: Jang
keywords: Metastasectomy; Neoadjuvant chemotherapy; Osteosarcoma; Recurrence