Abstract
Achieving negative surgical margins is a critical objective in osteosarcoma management, directly linked to reduced local recurrence and improved survival. This review comprehensively examines the evaluation techniques and clinical significance of these margins. We discuss the ongoing debate surrounding the optimal margin width and the impact of neoadjuvant chemotherapy on this standard. The application of conventional imaging (X-ray, CT, MRI) and advanced technologies (radiomics, fluorescence imaging, robot-assisted surgery) for margin assessment is analyzed. Furthermore, we explore treatment strategies to secure negative margins. By synthesizing current evidence, this article aims to guide clinicians in margin selection and highlights future directions for improving oncological outcomes.