Five-year relative survival of metastatic osteosarcoma by decade, based on the Surveillance, Epidemiology, and End Results (SEER) 9 database, 1975 to 2015. Five-year relative survival rates within each age group were compared by decade with 2010 to 2015 as the comparison group. Significantly different survival rates (P < .05) using the Z test are marked with (*). The 0- to 9-year-old and 10- to 24-year-old age groups were combined to have sufficient number of cases for analysis. Number of total years per decade group varies based on available years in the SEER database. The 25- to 59-year-old age group (B), 1975 to 1979 decade is based on only 9 cases.