**9. Conclusions**

The current standard of care for a patient with newly diagnosed osteosarcoma includes 2 cycles of MAP neoadjuvant chemotherapy followed by local tumor surgery and 29 weeks of adjuvant MAP chemotherapy. With this standard approach, disease-free survival is approximately 70% in patients with localized disease at the time of diagnosis.

Treatment outcomes for patients with osteosarcoma, for localized, metastatic, or relapse patients, have not improved significantly and have not gotten better in the last 10 years, despite many improvements and extensive studies.

The poor results of patients with low necrosis during surgery after neoadjuvant chemotherapy still appear as a treatment challenge. It has been shown that intensified chemotherapy methods, which have been emphasized in recent years, are not superior to conventional treatment. It is clear that more work is needed.

#### **Conflict of interest**

The authors declare no conflict of interest.

*Recent Advances in Bone Tumours and Osteoarthritis*
