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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2002 December;53(4):195-204
High-grade osteosarcoma of the extremities
Fagioli F., Palmero A., Berger M., Gastaldo L., Pessolano R., Berta M., Brach Del Prever A., Madon E.
The prognosis of patients with high grade osteosarcoma has greatly improved over the past 25 years with overall survival rates rising from 15% to 70%. This improvement is attributed to: 1) the effect of preoperative chemotherapy; 2) the introduction of aggressive chemotherapy with various combinations of high-dose methotrexate, adriamycin, cisplatinum and ifosfamide; 3) the identification of the relationship of dose-response between methotrexate, adriamycin, cisplatinum and osteosarcoma cells; 4) the recognition of the main prognostic factor, such as the histological response to preoperative chemotherapy, which might change postoperative chemotherapy. In this review, the therapeutic protocol for high grade osteosarcoma localized at the extremities, for metastatic osteosarcoma at diagnosis and for relapsed osteosarcoma will be briefly explained.