[Osteosarcoma 1978 a turning point in prognosis through adjuvant chemotherapy following adequate surgery (author's transl)].

Results of surgery and chemotherapy in osteosarcoma are based on a retrospective investigation of 122 patients from 1930 till 1978 treated at the Orthopaedic Department of Vienna University and documented at the Viennese Bone Tumour Registry. Adequate surgery is considered to be the radical elimination of the tumour in an oncological sense, e.g. amputation or resection. Our own patients were examined in this light and different forms of chemotherapy are compared and their efficacy as adjuvant treatment is evaluated. The turning point in the prognosis of osteosarcoma came with the introduction of high-dose methotrexate therapy (HDMTX) in 1972 and which has been employed at the Orthopaedic Department of Vienna University since 1975. So far, HDMTX has been used in the management of 18 patients and the short-term results confirm the excellent results reported in the literature. The consequent change in policy with regard to the current surgical approach to osteosarcoma is discussed in detail.