A decision tree analysis reveals significant interaction between tumor size and close surgical margins affecting outcomes in limb salvage surgery for high-grade osteosarcoma.

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Close surgical margins (CSM) in limb salvage surgery for high-grade osteosarcoma are linked to higher local recurrence rates.
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Larger tumor size is a significant risk factor for metastasis and overall survival in patients undergoing limb salvage surgery.
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A decision tree model indicates that the impact of close peri-neurovascular margins on survival is influenced by tumor size.
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Patients with small-sized osteosarcomas and close margins have a higher chance of local recurrence and poorer survival outcomes.
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For large-sized tumors, prognosis remains poor regardless of the status of close surgical margins.

Frontiers In Surgery

by Yingying Shi, Lan Wei, Qiyuan Bao, Junxiang Wen, Zhusheng Zhang, Zhuochao Liu, Qi Liu, Jie Chen, Xiaoqing Yang
April 24, 2026

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