Although the regimens of chemotherapy improved, about 30 - 35% of osteosarcomapatients however still had local or systemic relapse. The lung, involved in more than 80% ofall patients. Surgical remission is critical in the management of these challenging patients.Local control was achieved by amputation or by local excision. Treatment at diseaserecurrence should consist not only of local control with surgery but also systemic treatment,however, the difficulty lies in the number of effective agents of chemotherapy that remainavailable to these patients. Only 25% of patients are expected to survive 5 years afterrecurrence and 10-year survival is approximately 20%.