title: Delaying surgery with chemotherapy for osteosarcoma of the extremities.
abstract: Osteosarcoma is the most frequent primary cancer of bone. When treated by surgery alone, it is almost invariably followed by metastatic dissemination and death. This dismal prognosis can be improved dramatically by including chemotherapy in an interdisciplinary regimen. Today, two-thirds of patients with localised extremity primaries can achieve long-term survival with such intensive multimodal therapy. This article provides a summary overview of current pharmacotherapy in osteosarcoma of the extremities, focussing on the approach of preoperative 'neoadjuvant' chemotherapy and thus, the potential benefits and pitfalls of delaying surgery. Prospective, multi-institutional trials are essential in guaranteeing that as many patients as possible can benefit from modern, efficacious interdisciplinary therapeutic regimens and that further progress can be made.
authors.affiliation: Universitätsklinikum Münster, Cooperative Osteosarkomstudiengruppe (COSS), Klinik und Poliklinik für Kinderheilkunde und Jugendmedizin, Pädiatrische Hämatologie und Onkologie, Münster, Germany. coss@uni-muenster.de
authors.forename: Stefan S
authors.initials: SS
authors.lastname: Bielack
authors.forename: Jan-Nicolas
authors.initials: JN
authors.lastname: Machatschek
authors.forename: Silke
authors.initials: S
authors.lastname: Flege
authors.forename: Heribert
authors.initials: H
authors.lastname: Jürgens
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000601:surgery; D002986:Clinical Trials as Topic; D005121:Extremities; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods; D012516:Osteosarcoma / Q000188:drug therapy* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents