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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Do osteosarcomas hurt?

The early symptoms of osteosarcoma include pain, which initially is intermittent. As the condition progresses, this intermittent pain gradually becomes constant, and the intensity of the pain is parallel to the severity of the osteosarcoma, meaning the more severe the osteosarcoma, the more intense the pain. Additionally, you can also feel a lump forming on the affected limb, and this lump is clearly tender to touch. The third symptom is the occurrence of a limp. This limp is due to pain, which prevents the patient from bearing weight and walking for extended periods. Lastly, all osteosarcomas present symptoms such as anemia, pathologic fractures, and a low-grade fever.

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Written by Wang Cheng Lin
Orthopedics
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Osteosarcoma can exhibit which symptoms?

The symptoms of osteosarcoma, first of all, include pain. The severity of the tumor varies, and so does the accompanying pain. If the tumor significantly damages the bone, causing stimulation to the nerve endings of the periosteum, it will lead to increased pain; Secondly, there is a lump. A lump can be felt on the limb, but this lump also comes with significant tenderness. The growth rate of this lump depends on the condition; Third, there is limping. This limping is also due to limb pain, which causes progressive limping symptoms when walking, and prolonged limping can also lead to joint stiffness and muscle atrophy; Fourth, there are systemic symptoms. Any patient with malignant tumors will experience weight loss, anemia, and multi-organ failure, and may even suffer from pathological fractures.

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Written by Na Hong Wei
Orthopedics
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Is osteosarcoma treatable?

Osteosarcoma is not about whether it can be treated, but it must be treated. Moreover, the earlier the treatment, the higher the five-year survival rate. Currently, the treatment for osteosarcoma still primarily involves comprehensive therapy centered around surgery. With the advent of neoadjuvant chemotherapy, the five-year survival rate for osteosarcoma has significantly increased. Specifically, once osteosarcoma is diagnosed, extensive chemotherapy is administered before surgery. After chemotherapy, depending on the extent of tumor invasion, either radical segmental resection, limb-sparing surgery, or amputation is considered. Postoperative treatment also requires continued high-dose chemotherapy. In fact, if osteosarcoma is not treated, it metastasizes very quickly, primarily to the lungs. However, if the treatment is very early, timely, and correct, the current five-year survival rate has reached about 80%. Therefore, osteosarcoma can be treated, and the earlier the treatment, the better the outcomes.

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

The symptoms of recurrent osteosarcoma include the following points: Firstly, if osteosarcoma recurs, it can cause sudden severe pain in the affected limb. This pain tends to intensify as the disease progresses and may shift from intermittent pain to continuous pain. Secondly, there might be metastasis to the lungs or other parts of the body. In such cases, if lung metastasis occurs, the patient will experience significant chest tightness and breathing difficulties. Thirdly, recurrent osteosarcoma can also lead to weight loss, decreased appetite, and the occurrence of low-grade fever. Fourthly, if the tumor recurs, the patient’s joints and the affected limb's mobility will be significantly hindered, and this can also cause numbness in the affected limb.

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Written by Na Hong Wei
Orthopedics
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What are the symptoms of osteosarcoma?

Osteosarcoma is a very common malignant tumor, primarily occurring at the distal femur, proximal tibia, and proximal humerus. Its manifestations mainly include persistent pain at these three locations, which gradually worsens and is accompanied by nighttime pain. Secondly, there is local swelling; the surface of the tumor may feel warmer to the touch and may even exhibit prominent veins, leading to restricted joint movement near the tumor. Thirdly, some patients may exhibit signs of systemic deterioration, such as weight loss, anemia, and fatigue. Fourthly, osteolytic osteosarcomas often erode the bone cortex, eventually weakening the bone and leading to pathological fractures. Thus, the symptoms of osteosarcoma include persistent pain in specific areas accompanied by nighttime pain, local swelling, systemic deterioration, and pathological fractures in many patients.