OBJECTIVE: To evaluate the prognostic factors for the local recurrence of @entity421 in extremities treated with combined therapy. METHODS: Between 1992 and 2001, 189 @entity1 with non-metastatic @entity421 were treated. The average age at diagnosis was 18 years old. @entity5 were located in the distal femur in 86 @entity1 , proximal tibia in 52, and other locations in 51. @entity174 occurred in 22 cases. One hundred and sixteen @entity1 received combined therapy, 73 @entity1 underwent non-combined therapy ( @entity5 resection only or unfinished chemotherapy). In the combined therapy group, 90 @entity1 underwent limb salvage surgery and 26 @entity1 received amputations. In the non-combined therapy group, 42 @entity1 underwent limb salvage surgery and 31 @entity1 received amputations. With Chi-Square test, local recurrence rates were retrospectively evaluated in relation to gender, age, @entity5 site, pathologic fracture, serum level of alkaline phosphatase, protocol of chemotherapy, type of surgery, surgical margin, size of @entity5 , and postoperative chemotherapy. Multiple factors were analyzed by Logistic regression analysis. RESULTS: The 5-year-survival rate was 78.5% in the combined therapy group and 35.1% in the non-combined therapy group. Local recurrence rate was 16.6% (15 cases) in limb salvage surgery with combined therapy group (90 cases) and 38.1% (16 cases) in limb salvage surgery with non-combined therapy group (42 cases) (P<0.001). @entity3 rate was 28.4% (33 cases) in the combined therapy group (116 cases) and 65.7% (48 cases) in the non-combined therapy group (73 cases) (P<0.000). The local recurrence rate was significantly related to serum level of alkaline phosphatase after preoperative chemotherapy, type of surgery, surgical margin and chemotherapy protocol. Moreover, Logistic regression revealed that surgical margin and serum level of alkaline phosphatase after preoperative chemotherapy were the key factors affecting the local recurrence. CONCLUSIONS: The local recurrence is related to the surgical margin. The adequate surgical margin is very important for the limb salvage. The local recurrence is highly related to @entity3 . The inadequate surgical treatment would damage the survival of @entity1 with @entity421 .

[Prognostic factors for the local recurrence of XXXX in extremities treated with combined therapy].

@entity1 :: ('9606', 'Species') :: ['patients'] @entity174 :: ('MESH:D050723', 'Disease') :: ['Pathologic fracture'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'Tumors'] @entity421 :: ('MESH:D012516', 'Disease') :: ['osteosarcoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis', 'Metastasis']
@entity421 :: (MESH:D012516,Disease) :: ['osteosarcoma']
