What is osteosarcoma?

Written by Na Hong Wei
Orthopedics
Updated on January 23, 2025
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Osteosarcoma is a type of malignant tumor that occurs in the bones, generally classified as stage IIb. Common sites for osteosarcoma include the distal part of the bone, the proximal tibia, and the proximal humerus. It most commonly affects adolescents.

Clinically, it primarily presents as persistent pain, including nighttime pain. Swelling and limited joint function typically occur around the common sites. Additionally, there are general symptoms associated with cachexia, such as malnutrition, anemia, mild or high fever, or weight loss.

Fourthly, it is very prone to causing pathological fractures. Many osteosarcoma patients seek medical attention due to these fractures. Thus, osteosarcoma is a serious malignancy in the bones with a generally poor prognosis. Diagnosis and treatment of osteosarcoma are crucial; upon confirmation, timely treatment is necessary. The primary treatment approach is a combination therapy centered around surgery, typically involving preoperative chemotherapy, followed by surgical treatment and postoperative chemotherapy. Currently, the five-year survival rate for osteosarcoma has significantly improved, reaching approximately 70% to over 80%.

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Written by Na Hong Wei
Orthopedics
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Is osteosarcoma sensitive to chemotherapy?

Osteosarcoma is relatively sensitive to chemotherapy. Currently, the treatment of malignant tumors is primarily a comprehensive approach centered around surgery. However, the treatment of osteosarcoma should start with neoadjuvant chemotherapy, which involves administering a certain number of chemotherapy sessions, generally around six, before surgery. After chemotherapy, the tumor itself shrinks in size, pain is reduced, and the patient's cachexia also improves. At this point, choosing an optimal surgical method based on the tumor’s location and size becomes feasible, whether it involves amputation, limb-salvage, or other treatment methods such as the implantation of prosthetics. Postoperative chemotherapy is then administered. With this approach, there is a significant improvement in the five-year survival rate. Therefore, the treatment of osteosarcoma is inseparable from chemotherapy, requiring both preoperative and postoperative chemotherapy, making osteosarcoma quite sensitive to chemotherapy overall.

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Written by Wang Cheng Lin
Orthopedics
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What tests are done to diagnose osteosarcoma?

The most accurate diagnostic method for osteosarcoma is biopsy, where live tissue is extracted and sent for pathological examination. The positive rate of this method can reach over 90%. Besides biopsy, there are several other methods to examine such conditions. For example, X-rays can be taken to observe significant damage to the bone structure. Secondly, CT scans and MRI can be used to determine whether the bone tumor has infiltrated surrounding tissues. MRI can also detect if there are metastases to organs outside the lungs. The third method is radionuclide bone scanning, which primarily aims to check for distant metastases of osteosarcoma.

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Written by Peng Li Bo
Oncology
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The difference between sarcoma and osteosarcoma

The relationship between sarcoma and osteosarcoma is very simple; it is a relationship of containment where sarcoma includes osteosarcoma. Simply put, the concept of sarcoma is broader, and osteosarcoma is a subtype under it. Sarcoma itself also includes malignant tumors occurring in blood vessels, fat, nerves, and muscles, such as angiosarcoma, liposarcoma, rhabdomyosarcoma, and leiomyosarcoma, and, of course, osteosarcoma. However, both sarcoma and osteosarcoma are malignant tumors, and it's important to clarify this concept. Moreover, osteosarcoma is more common in young people.

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Written by Guan Jing Tao
Orthopedics
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Can patients with osteosarcoma have children?

Whether osteosarcoma patients can have children requires comprehensive consideration. One factor is that the patient's age should not be too old. Additionally, one must consider the individual's response after surgery and subsequent performance after treatment. Besides, regular check-ups should be conducted, and attempts to conceive can be made if there is no obvious abnormality or other pathological changes in the body. However, it is essential to conduct regular follow-ups and be mentally prepared. The possibility of various problems during pregnancy should not be ruled out, such as a decrease in immune response, which could trigger a recurrence of the bone tumor or other conditions, potentially leading to health issues for the child or the mother. Thus, a comprehensive and thorough evaluation is necessary.

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Written by Na Hong Wei
Orthopedics
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Symptoms of osteosarcoma

The common symptoms of osteosarcoma include, first, pain which is often persistent, typically occurring at the distal femur, proximal tibia, and proximal humerus. The characteristic of this pain is that it worsens at night, more severe than during the day. Second, there is local swelling usually near joints, particularly at the three aforementioned common sites. The skin over the swelling often becomes warm and may even show redness, and some patients may have dilated surface veins. The swelling can frequently cause dysfunction of nearby joints, or restricted function. Third, systemic symptoms primarily include a persistent wasting syndrome, known as cachexia. Fourth, osteosarcomas can weaken the bone's load-bearing capacity and strength following cortical bone involvement, eventually leading to pathological fractures. Therefore, the main symptoms of osteosarcoma are localized pain, local swellings, systemic manifestations of cachexia, or pathological fractures.