title: The multidisciplinary management of osteosarcoma.
abstract: Patients with suspected or confirmed osteosarcoma should be evaluated and treated at a comprehensive cancer center within a multidisciplinary sarcoma program that includes pediatric, medical and radiation oncologists, orthopedic and surgical oncologists, musculoskeletal pathologists, and radiologists. Successful treatment involves proper diagnosis, neoadjuvant and adjuvant multi-agent chemotherapy, and aggressive surgery with an emphasis toward limb-preserving procedures. Treatment of osteosarcoma should be undertaken within the framework of large cooperative group clinical trials for children, adolescents, and adults. Patients treated with osteosarcoma should be followed closely both for recurrence of disease and for development of late effects of the treatment of their cancer. The treatment of metastatic, recurrent and/or refractory disease is more controversial. Despite advances in systemic treatment, surgical technique, and supportive care, the overall outcome is still poor.
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
authors.forename: Noah
authors.initials: N
authors.lastname: Federman
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bernthal
authors.forename: Fritz C
authors.initials: FC
authors.lastname: Eilber
authors.forename: William D
authors.initials: WD
authors.lastname: Tap
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002173:Cancer Care Facilities / Q000458:organization & administration; D002648:Child; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D019468:Disease Management; D006801:Humans; D012516:Osteosarcoma / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D010166:Palliative Care; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D017741:Survivors; D035703:Therapies, Investigational; D016896:Treatment Outcome; D055815:Young Adult