The effect of local recurrence on survival in resected osteosarcoma

The aim of this study was to assess the effect of local recurrence on survi val in primary osteosarcoma. 559 patients entered into two randomised trial s of the European Osteosarcoma Intergroup who received surgery for primary operable high-grade osteosarcoma of the extremities were included in this a nalysis. Proportional hazards modelling techniques were used to assess the relative importance of sex, age, site, surgery performed and local recurren ce. The last of these uas considered as a time-dependent covariate. 42/559 (8%) patients had a local recurrence. In the multivariate: analysis, local recurrence was found to greatly increase the risk of death (hazard ratio (H R) = 5.10, 95% confidence interval (CI) 3.51-7.41). Site and surgery perfor med also had a significant influence within this model. Using the technique of landmark analysis, with the landmark time set at 18 months, local recur rence alone had a significant influence on survival (HR = 4.60. 95% CI 2.80 -7.57). Local recurrence is an indicator of poorer survival for patients wi th operable primary osteosarcoma. (C) 2001 Elsevier Science Ltd. All rights reserved.