One hundred thirty patients with high grade osteosarcoma were enrolled
in a randomized prospective multidisciplinary treatment that included
intraarterial chemotherapy, local irradiation, limb salvage surgery,
and prophylactic whole lung irradiation, The patients were evaluated t
o stage the prognostic factors, In a multivariate analysis, a minimal
level of serum lactic acid dehydrogenase less than 300 IU/L showed a s
ignificant prognostic value, The history of trauma before diagnosis of
disease, local irradiation of the affected site, histologic response
to preoperative multidisciplinary therapy, and prophylactic whole lung
irradiation were associated with significantly better prognosis in th
e log rank test, Patient age, site of the primary tumor, presentation
of fracture, pathologic subtype, signs and symptoms, serum alkaline ph
osphatase level, and erythrocyte sedimentation rate were not found to
be prognostic factors, The 9-year survival rate of the whole group was
55%.