Review Article

Osteosarcoma

Messerschmitt, Patrick J. MD; Garcia, Ryan M. MD; Abdul-Karim, Fadi W. MD; Greenfield, Edward M. MD; Getty, Patrick J. MD

Author Information

Dr. Messerschmitt is Resident, Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH. Dr. Garcia is Resident, Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University. Dr. Abdul-Karim is Professor, Department of Pathology, University Hospitals Case Medical Center, Case Western Reserve University. Dr. Greenfield is Professor and Director of Orthopaedic Research, Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University. Dr. Getty is Assistant Professor and Director of Graduate Orthopaedic Education, Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University, Director of Musculoskeletal Oncology, Ireland Cancer Center, Cleveland, OH, and Medical Director, Department of Orthopaedic Oncology, Louis Stokes VA Hospital of Cleveland, Cleveland, OH.

Reprint requests: Dr. Messerschmitt, Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University, 6th Floor Hanna House, 11100 Euclid Avenue, Cleveland, OH 44106.

Journal of the American Academy of Orthopaedic Surgeons 17(8):p 515-527, August 2009.

Abstract

Osteosarcoma, the most common bone sarcoma, affects approximately 560 children and adolescents annually in the United States. The incidence of new diagnoses peaks in the second decade of life. Twenty percent of patients present with clinically detectable metastases, with micrometastases presumed to be present in many of the remaining patients. Treatment typically includes preoperative chemotherapy, surgical resection, and postoperative chemotherapy. Limb-salvage procedures with wide surgical margins are the mainstay of surgical intervention. Advances in chemotherapy protocols have led to a 5-year survival rate of 60% to 78%. Among the goals of future treatment regimens are improved chemotherapeutic agents with higher specificity and lower toxicity.