title: A meta-analysis of randomized control trials of surgical methods with osteosarcoma outcomes.
abstract: BACKGROUND
  Osteosarcoma is a high malignant neoplasm, and conflicting findings have been reported on the survival and function recovery of osteosarcoma patients experiencing limb salvage or amputation. In the present study, we compared limb salvage surgery (LSS) with amputation in clinical outcomes of osteosarcoma patients by a meta-analysis.
  
  
  METHODS
  The survival rate of osteosarcoma patients was collected from research reports from CNKI, MEDLINE, EMBASE, the Cochrane Database, and Google Scholar till April 30, 2016. The quality of including articles was evaluated by two independent reviewers. Differences between patients undergoing limb salvage surgery and amputation were analyzed based on postoperative survival rates.
  
  
  RESULTS
  Ten articles were included according to selection criteria. There were 1343 patients in total from these studies. Our results showed that there was no significant difference between limb salvage surgery and amputation according to local recurrence; however, patients with limb salvage surgery had a higher 5-year overall survival.
  
  
  CONCLUSIONS
  LSS results in higher 5-year survival rates and better survival, while not increasing the risk of local recurrence. This study provided more evidences to support limb salvage surgery as a considerable treatment of osteosarcoma patients.
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Jiaxing College, 1518 Huancheng Rd, 314000, Jiaxing, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Oncology, The Second Affiliated Hospital of Jiaxing College, Jiaxing, China.
authors.forename: Zhenzhen
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Jiaxing College, 1518 Huancheng Rd, 314000, Jiaxing, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Jiaxing College, 1518 Huancheng Rd, 314000, Jiaxing, China.
authors.forename: Zhongwei
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Jiaxing College, 1518 Huancheng Rd, 314000, Jiaxing, China. fupeng24@163.com.
authors.forename: Peng
authors.initials: P
authors.lastname: Fu
mesh_terms: D000671:Amputation, Surgical / Q000379:methods*; D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage / Q000379:methods* / Q000401:mortality; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D012516:Osteosarcoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D016879:Salvage Therapy / Q000379:methods / Q000401:mortality; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: 5-year overall survival; Amputation; Limb salvage surgery; Local recurrence; Meta-analysis