Adjuvant Chemotherapy in the Treatment of Osteosarcoma: Results of the Multi-Institutional Osteosarcoma Study

The prognosis for children with osteosarcoma has improved dramatically over the past 15 years. Prior to 1970, fewer than 20% of patients with osteosarcoma treated only with surgery of the primary tumor survived 5 years (1,2), and it was inferred from the experience at multiple institutions that at least 80% of patients presenting without overt metastatic disease, in fact, had microscopic subclinical metastases at the time of diagnosis. Today, projected 5-year survivals of 60–80% are reported from a number of treatment centers. This improvement in prognosis for more recently diagnosed patients with osteosarcoma had been attributed to the administration of adjuvant chemotherapy after surgery which apparently was effective in eradicating micrometastatic disease.