Prognostic significance of alpha V integrin and VEGF in osteosarcoma after chemotherapy. alpha V integrins and vascular endothelial growth factor (VEGF) have been shown to play an important role in osteosarcoma metastasis. However, their expression in osteosarcoma after chemotherapy remains unknown.Here, using immunohistochemistry, we analyzed the levels of alpha V integrins and VEGF in paraffin sections of 20 patients with untreated osteosarcoma, and 31 patients with adriamycin/cisplatin/ifosfamide-treated osteosarcoma.Expression of alpha V integrins and VEGF was much higher in osteosarcoma compared with normal bone tissues (p < 0.001) and was reduced dramatically after adriamycin/cisplatin/ifosfamide treatment (p < 0.01). Their expression in osteosarcoma after chemotherapy positively correlated with each other (r = 0.418; p = 0.019, Spearman test). The rank sum test indicated that both positively correlated with osteosarcoma relapse (p < 0.01 and p < 0.05, respectively), Enneking stages (p < 0.05), and invasion of osteosarcoma (p < 0.05), but not with gender, age, tumor necrosis, tumor subtype, or location. VEGF expression was also associated with metastasis incidence (p < 0.05). Multinomial forward conditional logistic regression analysis showed that alpha V integrins might be an independent risk factor of osteosarcoma relapse (odds ratio = 3.96, p = 0.047, 95% confidence interval = (2.12-12.47)).Expression of alpha V integrins and expression of VEGF may be helpful indicators of osteosarcoma diagnosis and predictors of prognosis after chemotherapy, serving as putative targets for osteosarcoma treatment.(c) 2008 S. Karger AG, Basel.