How should osteosarcoma be treated?

Written by Guan Yu Hua
Orthopedic Surgery
Updated on May 23, 2025
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Osteosarcoma is a malignant tumor that devours bone, commonly occurring in adolescents and young adults, typically at the proximal end of the tibia or the distal end of the femur, and at the proximal end of the humerus in the upper limbs, which is the metaphysis. The main clinical symptoms are pain, which becomes more pronounced at night, and there is generally a mass at the site, with limited movement. The local skin temperature may increase, and some may exhibit distended veins. Patients with malignant tumors generally gradually lose weight, eventually developing cachexia and even pathological fractures. Osteosarcoma is asymptomatic in its early stages, and once detected, it is usually in the middle to late stages. Radiographic examinations are necessary for diagnosis, typically showing specific changes such as Codman’s triangle or a sunburst pattern, which are characteristic of osteosarcoma. Surgery is necessary at times, to remove and examine the pathology. Common surgical approaches include resection with inactivation and reimplantation, or the insertion of a prosthesis for limb-sparing procedures, while another option is amputation, followed by extensive chemotherapy. With the rapid advancements in chemotherapy in recent years, the survival rate for osteosarcoma has generally increased significantly, typically about 50% over five years. However, early-stage pulmonary metastasis occurs very frequently with osteosarcoma, necessitating early diagnosis and treatment. The primary treatment is surgical, complemented by postoperative chemotherapy.

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Written by Wang Cheng Lin
Orthopedics
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early symptoms of osteosarcoma

The early symptoms of osteosarcoma mainly include the following types: First, pain - patients will experience obvious pain in the affected limb. Second, lumps - lumps can be felt on the affected limb, accompanying significant tenderness. The growth rate of such lumps is directly related to your pathology and the course of your disease; the more severe your condition, the larger the lump. Third, limping - limping is caused by chronic pain in the affected limb. Over time, there may also be limited joint mobility and muscle atrophy in the affected limb. Fourth, symptoms such as fever, weight loss, and anemia may occur. Furthermore, in the middle and late stages of osteosarcoma, pathological fractures might occur.

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Written by Na Hong Wei
Orthopedics
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Osteosarcoma diagnostic methods

Osteosarcoma Diagnostic Methods: In clinical practice, once osteosarcoma is suspected in a patient, the diagnostic approach, as per the Chinese Cancer Treatment Guidelines, requires a combination of clinical symptoms, radiological data, and pathology. Only through the integration of these three elements can a definitive diagnosis of osteosarcoma be established. Reliance solely on pathology, or exclusively on radiologic examination or clinical examination, can lead to biased results. Given that immediate treatment is crucial upon the discovery of osteosarcoma, and considering the severe implications of treatment costs, patient suffering, and other related issues, it is vital that the diagnosis of osteosarcoma is error-free. To ensure absolute certainty, the approach should involve clinical symptoms supplemented by necessary auxiliary examinations such as X-rays and CT or MRI scans, followed by a diagnostic biopsy for pathological results. This comprehensive combination generally prevents the occurrence of missed or misdiagnoses in patients with osteosarcoma. Therefore, the confirmatory diagnosis of osteosarcoma should not rely solely on one type of examination but should combine clinical assessment with necessary imaging data and pathology to finalize the diagnosis process.

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Written by Na Hong Wei
Orthopedics
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Is osteosarcoma serious?

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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Written by Guan Jing Tao
Orthopedics
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Can hot compresses relieve pain for osteosarcoma?

Osteosarcoma has very limited pain relief effects through simple or pure hot compresses. As the lesion progresses, hot compresses can become completely ineffective or have very unclear effects. Clinical manifestations include pain and swelling, with local formation of lumps or tumor-like appearances. It can also affect the joint mobility around it, and even cause atrophy of limbs and muscles. In terms of treatment, it still relies on early surgical excision, but the prognosis is still not very optimistic.

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Written by Wang Cheng Lin
Orthopedics
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Osteosarcoma common onset age

Osteosarcoma most commonly occurs in adolescents under the age of 20, or in children, and is a type of malignant tumor. It is the most common malignant bone tumor in children, accounting for about 5% of all malignant tumors in children, making this age group highly susceptible to osteosarcoma. The formation of osteosarcoma is mainly due to external factors such as viral infections and genetic mutations that lead to cell mutations. Osteosarcoma is a typical malignant tumor that destroys bone and surrounding soft tissue, leading to pathological fractures. It can also form distant metastases, thus posing a significant threat.