Patient Update / Brandon

Patient Update / Osteosarcoma


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Osteosarcoma

Osteosarcoma is the most common type of bone cancer in children and adolescents. It occurs most often in the bones on either side of the knee and in the upper arm. It most commonly arises from the metaphysis (the wider part) of the bone.

Each year in the United States, osteosarcoma is diagnosed in approximately 400 children and adolescents younger than 20. The peak incidence is in the second decade of life, during the adolescent growth spurt. It is extremely rare in children before the age of 5. Osteosarcoma is somewhat more likely to affect males than females. The incidence in black children is higher than that in whites. The cause of osteosarcoma is unknown; however, irradiation and genetic influences have been implicated in its development.

Patients usually suffer from pain, swelling and sometimes decreased joint motion. Occasionally, a patient may have a fracture at the tumor site. Symptoms are usually present for several months before the diagnosis is made.

About 15-20 percent of the patients have metastatic disease at the time of diagnosis – usually in the lung and the bones. Currently, the estimated 5-year survival for patients with osteosarcoma is 65 percent compared with 15 percent in the early 1960s. Treatment includes surgery and chemotherapy. Surgical removal of all gross and microscopic tumor is required to prevent local tumor recurrence. Before the 1970s, amputation was the only surgical approach. Currently, 95 percent of patients with localized osteosarcoma of the extremity can be considered for limb-salvage surgery.

When osteosarcoma is treated by surgery alone, the natural history is recurrence and more than 80 percent of patients will develop metastatic disease. In the past 20 years, the use of chemotherapy has markedly improved the outcome of patients with osteosarcoma.