ReviewCureus2025
Age Matters: A Systematic Review of Limb-Salvage Surgery Outcomes in Pediatric Versus Adult Osteosarcoma.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Osteosarcoma Across the Age Spectrum: Why Outcomes Diverge and Trials Must Adapt.Journal of clinical medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Limb-salvage surgery (LSS) is the cornerstone of modern osteosarcoma management, yet outcomes appear to differ substantially between pediatric and adult patients. Variability in tumor biology, chemotherapy tolerance, treatment intensity, and reconstructive durability may contribute to age-related disparities; however, comparative evidence has not been previously synthesized. This study aimed to systematically evaluate oncologic, functional, and prognostic differences in limb-salvage outcomes between pediatric and adult patients with osteosarcoma. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review was performed across major databases. Studies were eligible if they reported limb-salvage outcomes separately for pediatric and adult patients. Data extraction encompassed survival, recurrence, functional scores, chemotherapy response, and prognostic factors. Risk of bias was assessed using the Newcastle-Ottawa Scale. Seven studies met the inclusion criteria, representing over 12,000 patients from cooperative trials, national registries, and institutional cohorts. Pediatric patients consistently demonstrated superior oncologic outcomes, with higher five-year overall survival (55%-73% vs. 41%-69%) and lower distant recurrence rates compared with adults. Local recurrence remained low but was slightly more frequent in adults. Functional outcomes favored pediatric groups, who achieved higher MSTS scores and lower revision rates. Histologic response to chemotherapy ≥90% was substantially more common in children, reflecting stronger systemic treatment tolerance. Predictors of poor outcome, such as axial site, metastatic disease, comorbidities, and poor necrosis, were disproportionately represented in adult cohorts. Risk of bias was low to moderate for most studies, with consistent age-related patterns across all evidence sources. Age significantly influences outcomes following LSS for osteosarcoma. Pediatric patients show superior survival, lower recurrence, improved function, and more favorable prognostic indicators compared with adults, even within similar surgical pathways. Biological differences, treatment intensity, and systemic therapy responsiveness likely contribute to these disparities. Future research should focus on optimizing chemotherapy strategies and reconstructive approaches for adults and on identifying biologic drivers that underlie these age-dependent patterns.
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Registered trials
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