Effect Of Limb Salvage Surgery And Amputation On Prognosis Of Patients With Osteosarcoma Of The Limb:A Meta-Analysis

Objective: Osteosarcoma is one of the most common primary malignant bone tumors.At present,the main treatments for osteosarcoma are neoadjuvant chemotherapy and surgical resection,which generally include limb salvage surgery and amputation.However,there is no consensus on the best choice of surgical method.Based on this status,we analyzed 5-year survival rate(OS),5-year disease-free survival rate(DFS)and local recurrence(LR)of patients with primary osteosarcoma of extremities who completed neoadjuvant chemotherapy before surgery with limb salvage surgery and amputation.Methods: The relevant studies published from January 2002 to December 2022 were searched from Pubmed,Embase and Cochrane Library.Data extraction and quality evaluation were conduct by two independent investigators.The combined values of odds ratios(OR)and 95% confidence intervals for 5-year OS,5-year DFS and LR were calculated using Revman5.3 software.Results: 9 studies were included that met the criteria with a total of 2677 patients with osteosarcoma,of whom 1959 underwent limb salvage surgery and 718 underwent amputation.The results showed that 5-year OS,5-year DFS and LR of patients receiving limb salvage surgery were higher than those receiving amputation,and the differences were statistically significant.Conclusions: Despite a higher local recurrence rate,limb salvage surgery does not reduce survival compared with amputation.On the contrary,limb salvage surgery significantly improves 5-year OS and 5-year DFS in patients with osteosarcoma of the limbs.