Osteosarcoma etiology

Written by Wang Cheng Lin
Orthopedics
Updated on February 15, 2025
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Currently, in clinical practice, the pathogenesis of osteosarcoma is not fully understood. However, it may be related to genetics, exposure to radioactive materials, and viral infections. It can also be secondary to other deformative osteitis, fibrous dysplasia, and some benign tumors transforming into malignant bone tumors. Osteosarcoma primarily occurs in the metaphysis of long bones. The tumor spreads along the marrow cavity, extending towards both the metaphysis of the long bones and the diaphysis of the bones. Once the tumor breaks through the bone shaft, it rapidly destroys the cortical bone, spreads under the periosteum, and invades the surrounding soft tissues outside the eardrum, damaging the surrounding muscles and soft tissues.

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Written by Na Hong Wei
Orthopedics
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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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Is there a cure for osteosarcoma?

Osteosarcoma is treatable, but it requires proper medical treatment. Currently, adjuvant chemotherapy significantly improves the five-year survival rate for osteosarcoma. The main treatment approach is still surgery as part of a comprehensive therapy. Specifically, the first step involves adequate preoperative chemotherapy, generally no fewer than six sessions over about eight weeks, or approximately two months. After this, patients often experience reduced pain, weight gain, improved positioning of the tumor, and a decrease in tumor size. Depending on the specific situation, a decision is made on the type of surgery to be performed—whether to amputate, preserve the limb, install a prosthetic, or use artificial bone as a replacement. Postoperative chemotherapy is usually also required to help ensure that the tumor does not recur and to increase the five-year or ten-year survival rate. Therefore, the current five-year survival rate for osteosarcoma has increased from the previous 40%-50% to about 80%. So, as long as one chooses the right hospital and the right treatment plan, and maintains confidence, osteosarcoma is usually treatable.

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Written by Wang Cheng Lin
Orthopedics
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Characteristics of bone metastasis in osteosarcoma

Osteosarcoma, when it metastasizes to the bone, is very complex to treat. Surgery cannot fully excise the metastasized bone tissue. Currently, clinical treatments mainly involve a comprehensive approach using radiotherapy, chemotherapy, and traditional Chinese medicine. Most osteosarcomas show improvement in symptoms and an increase in patients' quality of life after radiotherapy and chemotherapy treatment. However, these treatments have their complications. For instance, while killing tumor cells, they can also damage normal cells, resulting in a decreased immune response and various related complications. Ultimately, this might lead to the cessation of radiotherapy and chemotherapy treatments. Therefore, current treatments for bone metastases from osteosarcoma involve using radiotherapy and chemotherapy in conjunction with traditional Chinese medicine. Traditional Chinese medicine may enhance the efficacy of radiotherapy and chemotherapy while also reducing their toxicity. (The use of medications should be under the guidance of a professional doctor.)

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Written by Wang Cheng Lin
Orthopedics
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What are the symptoms of osteosarcoma?

Symptoms of Osteosarcoma: The first is pain at the site of occurrence. This pain may be intermittent and not very pronounced in the early stages. As the condition progresses, the severity of the pain gradually increases, transitioning from intermittent to persistent pain; The second is the formation of a lump. You can feel a lump on the limb with your hand, and this lump is clearly tender to the touch; The third is limping, which is mainly caused by the pain in the limb; The fourth is the most common systemic symptoms. Patients with this malignant tumor will exhibit fever, weight loss, anemia, and pathological fractures. These are the main symptoms of osteosarcoma currently observed in clinical settings.

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Written by Wang Cheng Lin
Orthopedics
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The common sites of osteosarcoma

Osteosarcoma commonly occurs in the long tubular bones of the limbs, such as the femur, tibia, and humerus, especially near the joints of these long bones where the incidence is highest. In children, the distal femur and proximal tibia account for about three-quarters of all bone tumors. Osteosarcoma can also occur in the proximal humerus, the spine, and the ribs, although it is less common in these locations. The most frequent sites remain the long tubular bones in the limbs.