Bone sarcomas: Overview of management, with a focus on surgical treatment considerations.
Outcomes for patients with bone sarcomas have improved dramatically over the past 40 years, and most bone sarcomas today are treated with surgery and chemotherapy. The most common clinical findings in patients with bone sarcomas are pain and an enlarging bone mass, although pain is not generally a good indicator of malignancy. In general, any patient with a bone mass with indeterminate imaging findings should be referred to an orthopedic oncologist. Bone sarcomas are diagnosed after a biopsy, which is best performed by the surgeon who will be doing the curative resection. Postresection reconstruction of the affected limb is generally done with an allograft-prosthetic composite or a modular metallic prosthetic joint replacement device. Post-therapy follow-up at frequent and regular intervals is critical to assess for recurrence and lung metastasis.
Lietman
Steven A
SA
Director, Musculoskeletal Tumor Center, Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A41, Cleveland, OH 44195, USA. lietmas@ccf.org
Joyce
Michael J
MJ
D000671:Amputation, Surgical / Q000379:methods / Q000592:standards; D001706:Biopsy; D001859:Bone Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D000075202:Contraindications; D003937:Diagnosis, Differential; D006801:Humans; D007595:Joint Prosthesis; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging; D019637:Orthopedic Procedures / Q000534:rehabilitation; D012516:Osteosarcoma / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D014184:Transplantation, Homologous