Osteosarcoma surgery: Difference between revisions
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*If a limb-salvage procedure is feasible, a course of multi-drug chemotherapy precedes surgery to downstage the tumor, followed by wide resection of the bone and insertion of an endoprosthesis. | *If a limb-salvage procedure is feasible, a course of multi-drug chemotherapy precedes surgery to downstage the tumor, followed by wide resection of the bone and insertion of an endoprosthesis. | ||
*The outcome depend on different factors such as age, sex, site, size, and type but the most important predictor is the histologic degree of necrosis post induction chemotherapy; 90% histologic necrosis is associated with much better prognosis. | *The outcome depend on different factors such as age, sex, site, size, and type but the most important predictor is the histologic degree of necrosis post induction chemotherapy; 90% histologic necrosis is associated with much better prognosis. | ||
*Localized Osteosarcoma: Surgery. Combination chemotherapy is usually given before and after surgery. Surgery followed by radiation therapy when the tumor cannot be completely removed by surgery. | *Localized Osteosarcoma: | ||
:*Surgery. Combination chemotherapy is usually given before and after surgery. Surgery followed by radiation therapy when the tumor cannot be completely removed by surgery. | |||
*Metastatic Osteosarcoma: | *Metastatic Osteosarcoma: | ||
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:*Bone Metastasis or Bone with Lung Metastasis: Osteosarcoma spread to a distant bone and/or the lung. Treatment may include Combination chemotherapy followed by surgery to remove the primary tumor and the cancer that has spread to other parts of the body. More chemotherapy is given after surgery. Surgery to remove the primary tumor followed by chemotherapy and surgery to remove cancer that has spread to other parts of the body. | :*Bone Metastasis or Bone with Lung Metastasis: Osteosarcoma spread to a distant bone and/or the lung. Treatment may include Combination chemotherapy followed by surgery to remove the primary tumor and the cancer that has spread to other parts of the body. More chemotherapy is given after surgery. Surgery to remove the primary tumor followed by chemotherapy and surgery to remove cancer that has spread to other parts of the body. | ||
*Recurrent Osteosarcoma of Bone: | |||
:*Treatment of recurrent osteosarcoma and malignant fibrous histiocytoma of bone may include the following: | |||
:*Surgery to remove the tumor with or without chemotherapy. | |||
:*Samarium with or without stem cell transplant using the patient's own stem cells, aspalliative treatment to relieve pain and improve the quality of life. | |||
:*A clinical trial of new types of treatment for patients whose cancer cannot be removed by surgery. These may include targeted therapy. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 15:32, 24 September 2015
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Osteosarcoma Microchapters |
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Osteosarcoma surgery On the Web |
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American Roentgen Ray Society Images of Osteosarcoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]
Overview
Surgery
- Cure, if achievable requires aggressive surgical resection often with amputation followed by chemotherapy.
- If a limb-salvage procedure is feasible, a course of multi-drug chemotherapy precedes surgery to downstage the tumor, followed by wide resection of the bone and insertion of an endoprosthesis.
- The outcome depend on different factors such as age, sex, site, size, and type but the most important predictor is the histologic degree of necrosis post induction chemotherapy; 90% histologic necrosis is associated with much better prognosis.
- Localized Osteosarcoma:
- Surgery. Combination chemotherapy is usually given before and after surgery. Surgery followed by radiation therapy when the tumor cannot be completely removed by surgery.
- Metastatic Osteosarcoma:
- Lung Metastasis: When osteosarcoma spreads, it usually spreads to the lung. Treatment of osteosarcoma and MFH with lung metastasis may include Combination chemotherapy followed by surgery to remove the primary cancer and the cancer that has spread to the lung.
- Bone Metastasis or Bone with Lung Metastasis: Osteosarcoma spread to a distant bone and/or the lung. Treatment may include Combination chemotherapy followed by surgery to remove the primary tumor and the cancer that has spread to other parts of the body. More chemotherapy is given after surgery. Surgery to remove the primary tumor followed by chemotherapy and surgery to remove cancer that has spread to other parts of the body.
- Recurrent Osteosarcoma of Bone:
- Treatment of recurrent osteosarcoma and malignant fibrous histiocytoma of bone may include the following:
- Surgery to remove the tumor with or without chemotherapy.
- Samarium with or without stem cell transplant using the patient's own stem cells, aspalliative treatment to relieve pain and improve the quality of life.
- A clinical trial of new types of treatment for patients whose cancer cannot be removed by surgery. These may include targeted therapy.