{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:00:22Z","timestamp":1793314822626,"version":"4.5.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Osteosarcoma is the most frequent bone cancer occurring in children and adolescents aged 10\u201320 years. Several prognostic factors have been identified by studies done at western centers. The aim of our study was to identify the prognostic factors in Tunisian patients in order to improve their management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We reviewed the data of localized limb osteosarcoma patients treated in Salah Aza\u00efz Institute from January 1980 to December 2018. Patient\u2019s treatment and survival variables were assessed. Patients received a neoadjuvant chemotherapy and underwent surgery in an expert center. They received afterward an adjuvant chemotherapy depending on the tumor necrosis assessed by Huvos.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eighty-five patients were enrolled. Mean duration of follow-up was 30 months (range 1\u2013297 months). Males were 1.6 times more frequent, median age was 17 (from 1 to 62 years). Conventional osteoblastic osteosarcoma was the most frequent histological subtype (77%). Median tumor size was 10 cm. Femoral location was the most frequent (60%). The overall average history of symptoms was 103 days (4 to 423 days). The 5-year overall-survival was 38% and the event free survival 32%. Tumor site, lactate dehydrogenase levels, high methotrexate levels at 24 h, clinical evaluation of the tumor perimeter, surgery type and delay of relapse were found to affect overall survival. Tumor site, Lactate dehydrogenase levels and clinical evaluation of the tumor perimeter affected the progression free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Demographic characteristics of Tunisian patients are mainly the same than worldwide. Femoral site, normal level of lactate dehydrogenase, a clinical response during neoadjuvant treatment, an R0 surgery, a delay of relapse over 2 years and Median H24 Methotrexate level superior to 4.4 \u00b5mol\/l were associated with a better prognosis in our study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2309499020974501","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T12:32:06Z","timestamp":1607603526000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Prognostic factors in High-Grade Localized Osteosarcoma of the Extremities: The Tunisian Experience"],"prefix":"10.1177","volume":"28","author":[{"given":"Feryel","family":"Letaief","sequence":"first","affiliation":[{"name":"Salah Azaiez Institute, Medical Oncology Department, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7811-2948","authenticated-orcid":false,"given":"Salim","family":"Khrouf","sequence":"additional","affiliation":[{"name":"Salah Azaiez Institute, Medical Oncology Department, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosra","family":"Yahiaoui","sequence":"additional","affiliation":[{"name":"Salah Azaiez Institute, Medical Oncology Department, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9223-9259","authenticated-orcid":false,"given":"Adel","family":"Hamdi","sequence":"additional","affiliation":[{"name":"Salah Azaiez Institute, Pharmacy Chemotherapy Preparation Unit, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azza","family":"Gabsi","sequence":"additional","affiliation":[{"name":"Salah Azaiez Institute, Medical Oncology Department, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouna","family":"Ayadi","sequence":"additional","affiliation":[{"name":"Salah Azaiez Institute, Medical Oncology Department, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amel","family":"Mezlini","sequence":"additional","affiliation":[{"name":"Salah Azaiez Institute, Medical Oncology Department, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,12,7]]},"reference":[{"key":"bibr1-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-0284-9_1"},{"key":"bibr2-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1007\/s10269-006-0576-y"},{"key":"bibr3-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23169"},{"key":"bibr4-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2016.11.009"},{"key":"bibr5-2309499020974501","volume-title":"WHO classification of tumours of soft tissue and bone","author":"World Health Organization, International Agency for Research on Cancer","year":"2013"},{"key":"bibr6-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-006-0020-y"},{"key":"bibr7-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.20.3.776"},{"key":"bibr8-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24809"},{"key":"bibr9-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr491"},{"key":"bibr10-2309499020974501","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00449"},{"key":"bibr11-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1991.9.10.1766"},{"key":"bibr12-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-007-0330-x"},{"key":"bibr13-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21724"},{"key":"bibr14-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.7.1443"},{"key":"bibr15-2309499020974501","first-page":"489","volume":"15","author":"Delepine N","year":"1995","journal-title":"Anticancer Res"},{"key":"bibr16-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1179\/joc.1996.8.6.472"},{"key":"bibr17-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20608"},{"key":"bibr18-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.24.4028"},{"key":"bibr19-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-014-0936-1"},{"key":"bibr20-2309499020974501","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.84B3.0840395"}],"container-title":["Journal of Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2309499020974501","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2309499020974501","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2309499020974501","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:30:34Z","timestamp":1777595434000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2309499020974501"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,1]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,9,1]]}},"alternative-id":["10.1177\/2309499020974501"],"URL":"https:\/\/doi.org\/10.1177\/2309499020974501","relation":{},"ISSN":["1022-5536","2309-4990"],"issn-type":[{"value":"1022-5536","type":"print"},{"value":"2309-4990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,1]]},"article-number":"2309499020974501"}}