Osteosarcoma and Surgery

Osteosarcoma treatment: state of the art

“…At all ages above 10 years, the tumor is more common in males than females. Before age 10, girls are likely as boys to develop OS [12]. …”

“…Even with effective chemotherapy, OS is rarely cured without surgical resection [51]. The aim of surgery is to completely resect the tumor to produce the minimum risk of local recurrence and the maximum chance of overall survival [12]. In addition, surgery is required to reconstruct the patient's limb after resection of the tumor, leading to a better quality of life for the patient.…”

“…Surgery for local disease can be carried out with an amputation or limb salvage depending on location and extent of disease and response of primary tumor to preoperative chemotherapy [8]. Amputation is the only safe way of surgery especially in patients with extensive soft tissue components [12]. However, because most tumors arise around the knee joint, amputation is usually high above the knee or sometimes a disarticulation of the hip.…”

“…In these cases, limb salvage surgery (bone replacements) can be conducted instead but with increased risks of complications such as local recurrence. The number of patients likely to be at risk of LR depends on the margins of excision and the effectiveness of chemotherapy [12]. Currently, amputation has become a more infrequent choice of surgery due to improved adjuvant therapies, operative techniques, and diagnostic methods [9].…”

“…Endoprosthetic replacement is the most common option. Another interesting and attractive option is to use the individual's own bone, removing it, sterilizing it, and reimplanting it [12]. Special considerations for the skeletally immature patients need to be taken into account in reconstruction of the defect [8].…”