{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T21:25:43Z","timestamp":1768339543617,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2004,5,17]],"date-time":"2004-05-17T00:00:00Z","timestamp":1084752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2004,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Better predictors of outcome would allow improved risk\u2010adapted therapy for pediatric nonmetastatic osteosarcoma of the extremity. We investigated the predictive value of MR imaging\u2010based measures of absolute and relative tumor size and volume at the time of diagnosis. We also assessed the relation of tumor size to age and histologic response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively abstracted demographic, treatment history, and outcome information of patients treated on a single institutional protocol. A single pediatric oncologic radiologist manually measured each primary lesion and the affected native bone in three dimensions on MR images obtained at the time of diagnosis. Eight parameters of tumor size were analyzed for their value in predicting overall survival (OS) and event\u2010free survival (EFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age of the 42 patients was 13.5 years (range: 5.9\u201318.7 years); 50% were female and 74% were Caucasian. Absolute tumor volume was an important predictor of OS (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05); absolute tumor depth (analyzed as a continuous variable) was a significant predictor of OS (<jats:italic>P<\/jats:italic>\u2009=\u20090.018) and EFS (<jats:italic>P<\/jats:italic>\u2009=\u20090.036). Relative measures of tumor size were not found to predict outcome. No relation was seen between tumor size and histologic response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Absolute tumor size at the time of diagnosis is significantly predictive of OS and EFS. If validated in a larger study, this indicator should be used in the design of risk\u2010adapted treatment protocols for osteosarcoma. \u00a9 2004 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.20077","type":"journal-article","created":{"date-parts":[[2004,5,18]],"date-time":"2004-05-18T07:01:04Z","timestamp":1084863664000},"page":"723-728","source":"Crossref","is-referenced-by-count":52,"title":["Tumor size as a predictor of outcome in pediatric non\u2010metastatic osteosarcoma of the extremity"],"prefix":"10.1002","volume":"43","author":[{"given":"Sue C.","family":"Kaste","sequence":"first","affiliation":[]},{"given":"T.","family":"Liu","sequence":"additional","affiliation":[]},{"given":"C.A.","family":"Billups","sequence":"additional","affiliation":[]},{"given":"N.C.","family":"Daw","sequence":"additional","affiliation":[]},{"given":"C.B.","family":"Pratt","sequence":"additional","affiliation":[]},{"given":"W.H.","family":"Meyer","sequence":"additional","affiliation":[]}],"member":"311","published-online":{"date-parts":[[2004,5,17]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1081\/CNV-100102557"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(05)70540-X"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198606193142502"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.1.171"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.1.76"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1992.10.1.5"},{"issue":"1","key":"e_1_2_5_8_2","first-page":"367a","article-title":"Addition of ifosfamide and muramyl tripeptide to cisplatin, doxorubicin and high\u2010dose methotrexate improves event free survival (ESF) in localized osteosarcoma (OS)","volume":"20","author":"Meyers P","year":"2001","journal-title":"Proceedings of ASCO"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.20.3.776"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.3.848"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.9.2781"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.03.144"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.17.5.9308111"},{"key":"e_1_2_5_14_2","first-page":"1051","volume-title":"Principles and practice of pediatric oncology","author":"Link MP","year":"2002"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0720-048X(98)00050-3"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.167.5.8911182"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.1880010408"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010615)91:12<2230::AID-CNCR1253>3.0.CO;2-T"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1522-2586(199909)10:3<277::AID-JMRI8>3.0.CO;2-S"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19820315)49:6<1221::AID-CNCR2820490625>3.0.CO;2-E"},{"key":"e_1_2_5_21_2","first-page":"14","article-title":"Primary osteogenic sarcoma: Pathologic aspects in 20 patients after treatment with chemotherapy, en bloc resection and prosthetic bone replacement","volume":"101","author":"Huvos A","year":"1977","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21979"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-2171(97)80022-4"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198668090-00005"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002470000405"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-2998(05)80105-9"},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10599"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.271.5252.1079"},{"key":"e_1_2_5_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/scientificamerican0794-58"},{"key":"e_1_2_5_30_2","first-page":"5451","article-title":"Time\u2010dependent behavior of interstitial fluid pressure in solid tumors: Implications for drug delivery","volume":"55","author":"Netti PA","year":"1995","journal-title":"Cancer Res"}],"container-title":["Pediatric Blood &amp; 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