{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T02:47:41Z","timestamp":1774493261153,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,11,8]],"date-time":"2014-11-08T00:00:00Z","timestamp":1415404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Cancer Center Support (CORE)","award":["CA-21765"],"award-info":[{"award-number":["CA-21765"]}]},{"name":"Cancer Center Support (CORE)","award":["CA-23099"],"award-info":[{"award-number":["CA-23099"]}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"crossref"}]},{"name":"American Lebanese Syrian Associated Charities (ALSAC)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Limb\u2010sparing surgery for osteosarcoma requires taking wide bony resection margins while maximizing preservation of native bone and joint. However, the optimal bony margin and factors associated with recurrence and survival outcomes in these patients are not well established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>We conducted a retrospective review of outcomes in children and adolescents with newly diagnosed osteosarcoma from 1986 to 2012, where bony resection margins for limb\u2010sparing surgeries were decreased serially from 5 to 1.5\u2009cm. The association between bony margins and other surgicopathological factors with survival and recurrence outcomes was determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 181 limb\u2010sparing surgeries in 173 patients, planned and actual bony resection margins were not significantly associated with local recurrence\u2010free survival (LRFS), event\u2010free survival (EFS), and overall survival (OS)\u2014at median 5.8 years follow\u2010up, decreasing planned bony resection margins from 5 to 1.5\u2009cm did not significantly decrease survival outcomes. Multivariable analysis showed that the presence of distant metastases at diagnosis was associated with decreased LRFS, EFS, and OS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002, 0.005, and &lt;0.0001, respectively). Post\u2010chemotherapy tumor necrosis \u226490% was associated with decreased EFS and OS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001 and 0.022, respectively). Earlier years of treatment and pathologic fractures were associated with decreased OS only (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.018 and 0.008, respectively); previous cancer history and male gender were associated with decreased EFS only (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.043 and 0.023, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We did not observe significant increase in adverse survival outcomes with reduction of longitudinal bony resection margins to 1.5\u2009cm. Established prognostic factors, particularly histologic response to chemotherapy and metastases at diagnosis, remain relevant in limb\u2010sparing patients. Pediatr Blood Cancer 2015;62:246\u2013251. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.25307","type":"journal-article","created":{"date-parts":[[2014,11,8]],"date-time":"2014-11-08T09:47:05Z","timestamp":1415440025000},"page":"246-251","source":"Crossref","is-referenced-by-count":31,"title":["Influence of bony resection margins and surgicopathological factors on outcomes in limb\u2010sparing surgery for extremity osteosarcoma"],"prefix":"10.1002","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8333-1486","authenticated-orcid":false,"given":"Amos H.P.","family":"Loh","sequence":"first","affiliation":[{"name":"Department of Surgery St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Paediatric Surgery KK Women's and Children's Hospital Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiyun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armita","family":"Bahrami","sequence":"additional","affiliation":[{"name":"Department of Pathology St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fariba","family":"Navid","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Pediatrics College of Medicine University of Tennessee Health Science Center Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Beth","family":"McCarville","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianrong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W.","family":"Bishop","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Najat C.","family":"Daw","sequence":"additional","affiliation":[{"name":"Division of Pediatrics The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Neel","sequence":"additional","affiliation":[{"name":"Department of Surgery St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhaskar N.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Surgery St. Jude Children's Research Hospital Memphis 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