Neoadjuvant chemotherapy combined with limb salvage surgery in patients with limb osteosarcoma of Enneking stage II: a retrospective study

Neoadjuvant chemotherapy combined with limb salvage surgery in patients with limb osteosarcoma of Enneking stage II: a retrospective study Guangke Yuan,1,2 Jingming Chen,2 Dongjin Wu,1 Chunzheng Gao1 1Department of Orthopedics, The Second Hospital of Shandong University, Jinan, 2Department of Orthopedics, Yidu Central Hospital of Weifang, Weifang, Shandong, People’s Republic of China Objective: To explore the effect of neoadjuvant chemotherapy combined with limb salvage surgery in patients with limb osteosarcoma of Enneking stage II. Patients and methods: Medical records of 98 patients who met the inclusion criteria were retrospectively analyzed. Of these patients, 56 cases who received neoadjuvant chemotherapy combined with limb salvage surgery were listed as group A, while another 42 patients who received limb salvage surgery combined with adjuvant chemotherapy were listed as group B. The recurrence and metastasis rate, survival rate, limb function and incidence of adverse reactions were compared between the two groups. Results: All 98 patients completed the treatment in this study. Baseline characteristics showed no significant differences between group A and group B, including age, gender, tumor location, maximum tumor diameter and Enneking stage (all P>0.05). The total metastasis and recurrence rate of group A was significantly lower than that of group B (25.0% vs 47.6%, χ2=5.419, P=0.020). The Kaplan–Meier method showed that progression-free survival (PFS) (log-rank χ2=4.014, P=0.045) and overall survival (OS) (log-rank χ2=3.859, P=0.049) of group A were both significantly higher than those of group B. There was no significant difference in the incidence of grades III–IV adverse reactions between the two groups (all P>0.05). The excellent and good rate of limb function in group A was significantly higher than that in group B (83.9% vs 66.7%, χ2=3.982, P=0.046). Conclusion: Neoadjuvant chemotherapy combined with limb salvage surgery for patients with Enneking stage IIA or IIB limb osteosarcoma patients has better efficacy and can significantly improve limb function of patients. Keywords: limb osteosarcoma, neoadjuvant chemotherapy, limb salvage surgery, adjuvant chemotherapy