Methotrexate as Adjuvant Treatment for Primary Osteosarcoma

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Abstract
To the Editor: Although historically survival of patients treated for primary osteosarcoma has been poor, 1 recent observations indicate that this prognosis is improving.2 Several authors have suggested that adjuvant chemotherapy after surgery has produced most of this favorable shift in prognosis by dramatically extending the postoperative disease-free interval.3 4 5 6 For several years this view has been widely assumed to be correct, although none of the studies on which it was based included concomitant untreated controls.We have observed that improvement in the survival of patients with primary osteosarcomas, which was not related to the use of adjuvant chemotherapy, has been occurring . . .

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