{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:23:41Z","timestamp":1787801021775,"version":"build-2784847793"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The timing of local control (LC) is not well studied in osteosarcoma. We assessed the impact of the delay of LC on the survival outcome of patients with osteosarcoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of children (\u226418\u00a0years) with nonmetastatic extremity primary osteosarcoma at King Hussein Cancer Center from January 2005 until March 2020. Patients\u2019 demographics, disease characteristics, and outcomes were collected. Events were defined as death, progression, or relapse. Cox proportional hazards regression was used for univariable and multivariable comparisons of different covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010two patients were included; 41 (50%) were females; the median age was 12.5\u00a0years (range: 5.9\u201318). Sixty\u2010four patients (78%) underwent LC by limb\u2010salvage surgery. Fifteen patients (18%) had a delay of LC greater than or equal to 18\u00a0weeks. After a median follow\u2010up of 54\u00a0months (range: 8\u2013188), the 5\u2010year event\u2010free survival (EFS) and overall survival (OS) were 55.3% \u00b1 5.8% and 66.6% \u00b1 6%, respectively. On univariable analysis, LC greater than or equal to 18\u00a0weeks, progression before LC, amputation, and poor histologic response were associated with worse EFS (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.007, .007, .006, .002) and OS (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.01, .001, .006, .004). On multivariable analysis, LC greater than or equal to 18\u00a0weeks, progression before LC, and poor histologic response were associated with worse EFS (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001, .007, .002); and OS (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001, .007, .008). Male gender was associated with worse OS on univariable and multivariable analysis (both <jats:italic>p<\/jats:italic>\u00a0=\u00a0.02). After exclusion of patients with early progression before Week 11, good histologic response and LC less than 18\u00a0weeks were associated with better EFS (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.04 and .03). While good histologic response was associated with better OS (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.02), LC less than 18\u00a0weeks was not significant (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that delay in LC could have an impact on the outcomes in patients with osteosarcoma. However, further investigations involving larger sample sizes and longer follow\u2010up are necessary to fully comprehend the extent of this influence.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30752","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T13:59:54Z","timestamp":1698674394000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of delay of local control in nonmetastatic extremity primary osteosarcoma"],"prefix":"10.1002","volume":"71","author":[{"given":"Hadeel","family":"Halalsheh","sequence":"first","affiliation":[{"name":"Department of Pediatric King Hussein Cancer Center  Amman Jordan"},{"name":"Department of Pediatric The University of Jordan  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taleb","family":"Ismael","sequence":"additional","affiliation":[{"name":"Department of Pediatric King Hussein Cancer Center  Amman 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