文献类型：期刊文献

英文题名：Minimal residual disease and relapse surveillance in osteosarcoma: an action-linked framework integrating liquid biopsy and imaging biomarkers

作者：Huang, Guoli[1];Zhou, Yang[1];Wang, Hao[1];Ma, Xiucai[2]

第一作者：Huang, Guoli

通信作者：Ma, XC[1]

机构：[1]Gansu Univ Chinese Med, Clin Med Sch 1, Lanzhou, Peoples R China;[2]Gansu Prov Peoples Hosp, Dept Bone & Soft Tissue Oncol, Lanzhou, Gansu, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Prov Peoples Hosp, Dept Bone & Soft Tissue Oncol, Lanzhou, Gansu, Peoples R China.

年份：2026

卷号：61

外文期刊名：JOURNAL OF BONE ONCOLOGY

收录：;Scopus(收录号：2-s2.0-105050610461);WOS:【SCI-EXPANDED(收录号:WOS:001883187000001)】；

基金：This work was supported by the Young Science and Tech-nology Talent Innovation Project, Science and Technology Bureau of Lanzhou [grant number 2023-4-58] ; the Gansu Provincial Health Commission Project [grant number GSWSKY2021-013] ; and the Natu-ral Science Foundation of Gansu Province [grant number 24JRRA1059] .

语种：英文

外文关键词：Osteosarcoma; Minimal residual disease; Relapse surveillance; Liquid biopsy; Circulating tumor DNA; Imaging biomarkers; Radiomics

摘要：Osteosarcoma relapse surveillance remains dominated by scheduled imaging because salvage treatment depends on anatomical confirmation of pulmonary, local or extrapulmonary recurrence. However, radiological recurrence may occur after a biologically active phase in which residual viable disease or micrometastatic progression is already present but not yet localizable. This clinical-translational review reframes postoperative osteosarcoma surveillance as an action-linked decision workflow rather than a comparison of isolated biomarker technologies. Current evidence suggests that tumor-informed circulating tumor DNA (ctDNA) sequencing provides the strongest osteosarcoma-specific minimal residual disease (MRD) signal, with postoperative positivity associated with inferior event-free survival and, in selected patients, molecular detection preceding imaging-confirmed relapse or progression. Cell-free DNA methylation may offer a mutation-independent adjunct, whereas circulating tumor cells, extracellular vesicles and circulating microRNAs remain exploratory signals without validated postoperative surveillance actions. Chest computed tomography (CT) and local magnetic resonance imaging (MRI) remain indispensable for disease localization and treatment planning, while diffusion-weighted imaging, dynamic contrast-enhanced MRI and radiomics currently provide mainly local viability or risk-enrichment information rather than proven surveillance-intervention evidence. The near-term role of integrated biomarkers is therefore not to replace guideline-based imaging, but to define protocolized pathways for molecular-positive/ imaging-negative, imaging-positive/molecular-negative, concordant high-risk and concordant low-risk states. Future studies should test whether biomarker-triggered reassessment improves clinically meaningful outcomes, including resectability, second complete remission, clinical trial access, patient burden , survival, rather than simply documenting recurrence earlier.