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 Fang Da Zheng
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Are osteosarcomas sensitive to radiotherapy and chemotherapy?

Osteosarcoma is generally insensitive to radiotherapy, hence radiation therapy is not used for such diseases in clinical settings. Similarly, these diseases have a moderate sensitivity to chemotherapy, necessitating the use of relatively high doses of chemotherapy during treatment. The main mechanism of chemotherapy involves using a series of cytotoxic drugs to inhibit tumor growth. Although high-dose chemotherapy can effectively kill tumor cells, it can also damage some of the patient's normal cells, leading to severe reactions. If radical surgery is viable for these patients, then curative surgery is the preferred method of treatment.

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Written by Cheng Bin
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Is osteosarcoma highly malignant?

First of all, it is certain that osteosarcoma is very malignant. Once osteosarcoma is detected, it is necessary to actively prepare for surgery, rule out surgical contraindications, and then proceed with surgical treatment. During the surgery, efforts should be made to perform an extended resection, and if necessary, amputation may be required. After the surgery, the excised specimen must be sent for pathological examination to determine the pathological type. Then, based on the examination results, effective radiotherapy and chemotherapy should be chosen to control the possibility of recurrence or metastasis of osteosarcoma and to extend the patient's life as much as possible.

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Written by Guan Jing Tao
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How to alleviate the pain of osteosarcoma?

Pain in osteosarcoma patients is mostly caused by the cancer invading local bone tissue and other tissues, leading to pain, tenderness, and even sleeplessness. Therefore, the pain management follows a certain hierarchy, starting with non-steroidal anti-inflammatory drugs, followed by weak opioids, and finally strong opioids such as morphine. However, this only alleviates the pain and does not help with treatment. For early-stage osteosarcoma patients, pain management primarily involves surgery when necessary. For advanced-stage patients, it involves gradually increasing the dose of effective pain-relief medications to alleviate temporary pain. (Controlled drugs must be strictly used under the supervision of relevant physicians.)

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Written by Guan Yu Hua
Orthopedic Surgery
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Osteosarcoma Causes

Osteosarcoma is the most common malignant tumor of the bone and typically presents without symptoms in its early stages. The cause of osteosarcoma is unknown, and it often goes undetected until it has reached a moderate or advanced stage. It commonly develops at the distal end of the femur near the knee joint, at the proximal end of the tibia, or at the proximal end of the humerus, primarily at the end of the growth plate. The pain associated with osteosarcoma is usually persistent, especially severe at night, and can lead to symptoms such as anemia or general wasting. The tumor's surface may be warm to the touch, with prominent veins visible, and radiographic imaging might show a Codman's triangle, indicative of sunlight-like radiation patterns, as well as bone destruction and clear periosteal reaction. Surgical treatment is typically pursued, with amputation being the most common procedure, though limb-sparing surgeries are possible if the tumor is detected early enough. Some cases metastasize, most commonly to the lungs, requiring continued high-dose chemotherapy post-surgery to prolong survival. Generally, the five-year survival rate for osteosarcoma can exceed 50% with early diagnosis and treatment. The chances of survival heavily depend on the individual’s constitution, the timing of tumor detection, and the surgical intervention. The exact causes of osteosarcoma are unclear, and the potential for metastasis complicates treatment. Therefore, early surgical intervention is crucial for improving survival rates and enabling patients to maintain a normal life and work activities.

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How long is the latent period of osteosarcoma?

In clinical practice, there is no such thing as a latency period for malignant bone tumors, because these tumors progress very quickly. So, if you experience symptoms such as swelling and pain in the affected limb, if you can feel a mass, and if the pain severely impacts your daily life, you should promptly go to a hospital to get an imaging test done to determine whether a bone tumor is present. Only through imaging and accurate diagnosis can early diagnosis and treatment be achieved, which is the best treatment approach for osteosarcoma. Therefore, in clinical practice, there is no concept of a latency period for malignant bone tumors.