OS patients with high ALDH1A1 RNA expression showed improved overall survival in examining a national genomic database of OS patients but again without association with disease-free survival. The potential of CD44 and ALDH1A1 as cellular-specific prognostic markers of survival, and as possible molecular targets, may be limited. The continued search for new cellular treatment response surrogates remains critical to advance beyond nonspecific tumor necrosis as the primary prognostic marker. The gene discussed is ALDH1A1; the disease is neoplasm.