Is osteosarcoma serious?

Written by Na Hong Wei
Orthopedics
Updated on September 03, 2024
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Osteosarcoma is a fairly serious condition. It is a type of malignant bone tumor and is classified as stage II according to the Eric staging system. Regardless of the treatment method used for osteosarcoma, the first issue is that it metastasizes quickly, and the second is that it tends to recur frequently. Therefore, once someone has osteosarcoma, it poses significant challenges, not only being difficult to treat but also involving considerable treatment costs. However, thanks to the efforts of researchers, a new adjuvant chemotherapy has been developed which has increased the five-year survival rate of osteosarcoma from 47% to about 80%, which is quite remarkable. Moreover, with this new adjuvant chemotherapy, patients first undergo chemotherapy, followed by surgery, during which chemotherapy is administered again, not only improving the five-year survival rate but also enhancing the quality of life for patients. Therefore, osteosarcoma is a very serious disease. In the past, amputation was common, followed by distal metastasis, so it didn't take long for metastases to appear in the lungs or brain. Thus, osteosarcoma is an extremely serious disease.

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incidence of osteosarcoma

Osteosarcoma, also known as osteogenic sarcoma, is a primary malignant tumor of the bone and has a relatively high incidence rate. Among primary bone tumors, the incidence of osteosarcoma is second only to plasma cell myeloma, ranking second. Osteosarcoma typically occurs in tubular bones, commonly affecting the rapidly growing metaphyseal regions. The distal femur, proximal tibia, and proximal humerus are the most frequently affected sites. Between 50%-70% of all cases occur around the knee joint. The common age range for this disease is between 10 to 20 years old, with a higher prevalence in males than in females.

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Symptoms of osteosarcoma recurrence

Osteosarcoma is a relatively common type of malignant bone tumor, ranking second in incidence among malignant bone tumors. Typically, upon the development of osteosarcoma, surgery is required to scrape out the tumor focus, followed by limb-sparing or amputation surgery. Additionally, adjuvant radiotherapy and chemotherapy are employed. Generally, the local area may be maintained for a period, but the disease is prone to recurrence. There may be local recurrence at the site of surgery or distant recurrence, meaning tumor cells might seed and lead to tumors in other locations. Symptoms of both local and distant recurrences are similar to those at the initial onset, generally including significant pain, night pain, and rest pain. There will also be distinct X-ray signs of osteosarcoma in the bone. Furthermore, osteosarcoma may metastasize to the lungs, potentially causing symptoms such as cough, bloody sputum, phlegm, and fever—typical signs of intrapulmonary tumors. These are some of the common symptoms associated with the recurrence of osteosarcoma.

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Written by Na Hong Wei
Orthopedics
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What is osteosarcoma?

Firstly, osteosarcoma is a common type of malignant tumor, characterized by a mechanism that produces bone-like tissue. It has multiple subtypes and can also develop into a secondary osteosarcoma. Secondly, it commonly occurs in adolescents. Thirdly, it typically affects the proximal femur, distal tibia, and proximal humerus. Fourthly, common osteosarcomas are generally spindle-shaped, often located near joints. The surface may have elevated skin temperature and sometimes superficial vein distension is apparent. It often involves the entire bone, including the periosteum, cortical bone, and bone cavity. Generally, the tumor appears as a very fine greyish-white or brownish-red fish-flesh-like change. Osteosarcoma is a malignant tumor and is particularly prone to lung metastasis. According to tumor staging, it is at least stage IIB, indicating that it should be detected, diagnosed, and treated early. The earlier the treatment, the better the outcome and the higher the five-year survival rate.

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Osteosarcoma is malignant.

Regarding whether osteosarcoma is benign or malignant, it is certain that osteosarcoma is a malignant tumor with a very high degree of malignancy. Once osteosarcoma is definitively diagnosed, aggressive treatment is necessary. Surgery is the main treatment approach, aiming to perform as extensive a resection as possible, or amputation may be required when necessary. After surgery, the resected specimen must be sent for pathological examination. Based on the type of pathology, the next step in treatment, either radiotherapy or chemotherapy, will be determined to minimize the recurrence of osteosarcoma, as a recurrence can endanger the patient's life.

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Characteristics of Osteosarcoma

Osteosarcoma is a malignant tumor of the bone that primarily occurs in adolescents and young adults, commonly found at the metaphyseal ends of long bones. For example, it may occur at the distal end of the tibia, the distal end of the femur, or the metaphyseal end of the humerus. Clinically, the main symptom is pain, which is persistent and more noticeable at night, accompanied by a local mass, limited movement, increased local skin temperature, distended veins, and general symptoms such as weight loss and even cachexia. Some patients may experience pathological fractures. Often, there are no symptoms in the early stages, and by the time it is detected, it is usually in an intermediate or advanced stage. Radiographic examination typically shows a Codman's triangle or sunburst pattern. Early detection and treatment are crucial. The usual treatment choice is surgical, such as deactivation and reimplantation, or limb-salvage surgery with prosthetic implantation. Additionally, amputation followed by extensive chemotherapy is another option. With recent advances in chemotherapy, there has been significant improvement in life extension.