Objective:Anti-angiogenic drugs are an emerging treatment option against malignant tumors.The aim of this study was to determine whether the addition of perioperative rh-endostatin to chemotherapy could improve the probability of distant metastasis-free survival (DMFS) and overall survival (OS) in patients newly diagnosed with non-metastatic conventional osteosarcoma.Methods:This was a controlled non-randomized clinical study that included 388 patients without clinically detectable metastatic disease enrolled from January 2008 to April 2012.The control treatment group had 272 patients;180 were male and 92,female,with a median age of 17 years.The treatment group had 58 patients;36 were male and 22,female,with a median age of 16 years.The control group received preoperative chemotherapy followed by surgery and postoperative chemotherapy.The treatment group received 4 cycles of rh-endostatin perioperatively in addition to chemotherapy as per the control group.Patients were followed up from 6-101 months with a median follow-up period of 50.2 months.Results:The 5-year DMFS of the control group (61％) was significantly lower than that of the rh-endostatin group (79％)(P =0.013).The 5-year OS of the control group (74％) was significantly lower than that of the rh-endostatin treatment group (87％) (P =0.029).No difference in adverse drug reactions was found between these 2 groups.Conclusions:The addition of perioperative rh-endostatin to chemotherapy could significantly improve the DMFS and OS of patients with non-metastatic osteosarcoma.