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Updated: Jun 23, 2026
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A Syngeneic Orthotopic Osteosarcoma Sprague Dawley Rat Model with Amputation to Control Metastasis Rate
Published on: May 3, 2021
Limb-sparing in patients with non-metastatic high-grade osteosarcoma
M Samardziski1, G Zafiroski, C Tolevska
1Department for Musculoskeletal Tumors, University Clinic for Orthopaedic Surgery, Skopje, FYROMakedonia. milan_samardziski@yahoo.com
Summary
This study on high-grade osteosarcoma found that neoadjuvant chemotherapy improved survival rates and enabled limb-sparing surgery for extremity tumors. The treatment protocol demonstrated significant benefits for patients with localized disease.
Area of Science:
- Orthopedic Oncology
- Medical Oncology
- Surgical Oncology
Background:
- High-grade osteosarcoma of the extremities presents a significant challenge in improving patient survival and functional outcomes.
- Neoadjuvant chemotherapy is a critical component in the multimodal treatment strategy for localized osteosarcoma.
- The Scandinavian Sarcoma Group XIV protocol represents a standardized approach to neoadjuvant chemotherapy for this patient population.
Purpose of the Study:
- To evaluate the efficacy of the Scandinavian Sarcoma Group XIV neoadjuvant chemotherapy protocol in improving survival and functional outcomes for patients with non-metastatic, high-grade osteosarcoma of the extremities.
- To assess the impact of neoadjuvant chemotherapy on the feasibility of limb-sparing surgery.
- To correlate histopathological response to neoadjuvant chemotherapy with patient survival.
Main Methods:
- A cohort of 30 patients with non-metastatic, high-grade osteosarcoma of the extremities received 2 cycles of neoadjuvant chemotherapy (methotrexate, cisplatin, doxorubicin) followed by surgery.
- Limb-sparing surgery was performed in 90% of cases, with amputation in the remaining 3 patients.
- Postoperative chemotherapy was administered, with additional cycles of ifosfamide for patients with poor histopathological response.
Main Results:
- Histopathological assessment revealed a poor response to neoadjuvant chemotherapy in 57% of patients, with no significant difference in 3-year survival between good and poor responders.
- Local recurrence significantly impacted survival (40% vs. 88% 3-year survival, p=0.013).
- Distant metastasis was associated with poorer outcomes (20% vs. 92% 3-year survival, p=0.0002), while overall 3-year survival was 80% and disease-free survival was 60%.
Conclusions:
- Neoadjuvant chemotherapy, as part of the Scandinavian Sarcoma Group XIV protocol, facilitates limb-sparing surgery in patients with high-grade osteosarcoma of the extremities.
- The regimen demonstrates potential for improving overall survival rates in this challenging patient group.
- Early detection and management of local recurrence and distant metastasis are crucial for optimizing patient outcomes.
