Fujiwara T, Medellin MR, Sambri A, et al. - A total of 226 patients with high-grade non-metastatic osteosarcoma in the limbs were reviewed by the researchers in order to ascertain the risk of local recurrence and survival in patients with osteosarcoma based on the proximity of the tumor to the major vessels. For types 1 to 4, respectively, limb salvage rate based on the proximity type was 92%, 88%, 51%, and 0% with overall survival of 82%, 77%, 57%, and 67%, respectively, at five years. In individuals with limb-salvage surgery, for the types 1 to 3, the local recurrence rate was 7%, 8%, and 22 %, respectively, and at the perivascular area, local recurrence for type 2 and 3 was noted in 1% and 4 %, respectively. For types 1 to 3, respectively, the mean microscopic margin to the major vessels was 6.9 mm, 3.0 mm, and 1.4 mm, respectively. Local recurrence-free survival with limb salvage in type 3 was significantly poorer in comparison with amputation whereas the latter gave no overall survival advantage. The risk of local recurrence in this group of people was decreased by factors such as good response to chemotherapy or limited vascular attachment to less than half circumference or longitudinal 10 mm. Hence, for local control and survival, the proximity of osteosarcoma to major blood vessels was concluded as a poor predictive factor. Moreover, for tumors attached to the blood vessels, amputation gave more valid local control yet it did not improve survival. Further, if the tumor attachment to blood vessels was limited, limb salvage surgery granted comparable local control.