incidence of osteosarcoma

Written by Li Jie
Orthopedics
Updated on November 11, 2024
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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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Written by Cheng Bin
Orthopedics
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Can osteosarcoma be detected on an X-ray?

First of all, it should be noted that osteosarcoma can be detected in patients through imaging tests. For example, a localized MRI can clearly diagnose osteosarcoma. Once detected, it is necessary to actively pursue symptomatic treatment. Surgical removal is usually the main treatment method, involving the excision of the affected area. If necessary, the excision may need to be extended, or amputation may be required. After surgery, the excised specimen should be sent for pathological examination. Based on the results of the pathology test, further radiation therapy or chemotherapy can be completely sufficient. The results are generally quite good for most patients.

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Written by Na Hong Wei
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What is osteosarcoma?

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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What are the symptoms of osteosarcoma?

The main symptom of osteosarcoma is localized pain, primarily at the distal end of the femur, the proximal end of the tibia, and the proximal end of the humerus. This pain tends to worsen continuously, with nighttime pain often more severe than during the day, which is a significant characteristic of osteosarcoma. The second symptom is the presence of a local mass, which is often spindle-shaped and generally located near a joint. This mass often leads to limited joint mobility, and the skin over the mass typically has a high temperature. Sometimes, it may also be accompanied by visible swelling of superficial veins. The third symptom involves systemic cachexia, which includes unexplained weight loss, generalized weakness, and even an anemic condition. The fourth point pertains to osteolytic osteosarcoma, which often leads to bone destruction, reduced bone strength, and consequently, even minor external forces can cause fractures. These are called pathological fractures. Thus, the symptoms of osteosarcoma generally include these four points.

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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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Written by Guan Yu Hua
Orthopedic Surgery
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How big do osteosarcomas generally grow?

The size of osteosarcoma is generally difficult to measure. By undergoing radiographic examination, Codman's triangle and bone destruction can be observed in the patient's images, which can be diagnosed as osteosarcoma. Further biopsy is then required. Osteosarcoma typically presents as a mass approximately the size of a fist, and early stages may involve malignant pulmonary metastasis. By conducting a pulmonary CT scan, lesions and metastatic foci can be discovered, primarily indicating bone destruction and the presence of Codman's triangle. Such destruction can deform the normal bone structure, and abnormal masses may be palpable during physical examinations, presenting in irregular shapes. This condition is commonly seen and cannot be evaluated merely by the size of the osteosarcoma. Early stages may involve lung metastasis, progressing to advanced stages where the prognosis is poor and survival rates significantly decrease. Therefore, this disease generally requires early diagnosis and treatment.