Osteosarcoma

Osteosarcoma is a bone tumor that occurs predominantly in adolescents and young adults. Our bones come in two main types: "flat" and "long". Flat bones help protect the brain and organs; long bones sport the legs and arms. Osteosarcoma usually develops at the edges of the long bones, in the "metaphysis", which is the name for the growing ends of the bone. Most of these tumors develop in the ends of the long bones that form the knee. The second most common site for these tumors is in the ends of the upper arm bone close to the shoulder. They can also be found in other places, like the pelvis, shoulder, and skull.

The World Health Organization's (WHO) classification of bone tumors separates the osteosarcomas into central (medullary) and surface (peripheral) tumors and recognizes a number of subtypes within each group.

• NCI site on cellular classification of osteosarcomas.

Treatment for Osteosarcoma

Osteosarcoma is treated with surgery and multi-agent chemotherapy. It is very important that patients are evaluated by an orthopedic oncologist who is familiar with the surgical management of osteosarcoma. This evaluation (including imaging studies) must be done prior to the initial biopsy, since a botched biopsy may jeopardize a limb-sparing procedure.
Patients with osteosarcoma should undergo surgical removal of the tumor if possible. The type of surgery depends on a number of factors, such as limb-sparing or replacement with prosthetic devices that must be evaluated on an individual basis. Chemotherapy can include high-dose methotrexate, doxorubicin, cyclophosphamide, cisplatin, ifosfamide, etoposide, and carboplatin.