title: Osteosarcoma treatment - where do we stand? A state of the art review.
abstract: Long-term outcome for patients with high-grade osteosarcoma has improved with the addition of systemic chemotherapy, but subsequent progress has been less marked. Modern, multiagent, dose-intensive chemotherapy in conjunction with surgery achieves a 5-year event-free survival of 60-70% in extremity localized, non-metastatic disease. A major, as yet unsolved, problem is the poor prognosis for metastatic relapse or recurrence, and for patients with axial disease. This article reviews the current state of the art of systemic osteosarcoma therapy by focusing on the experiences of cooperative osteosarcoma groups. Also, we shed light on questions and challenges posed by the aggressiveness of the tumor, and we consider potential future directions that may be critical to progress in the prognosis of high-grade osteosarcoma.
authors.affiliation: Pediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Luetke
authors.affiliation: Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Meyers
authors.affiliation: Alder Hey Children's NHS FT, Liverpool, United Kingdom.
authors.forename: Ian
authors.initials: I
authors.lastname: Lewis
authors.affiliation: Pediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany. Electronic address: jurgh@uni-muenster.de.
authors.forename: Heribert
authors.initials: H
authors.lastname: Juergens
mesh_terms: D001859:Bone Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D060787:Neoplasm Grading; D012516:Osteosarcoma / Q000473:pathology / Q000628:therapy*
keywords: Interferon α; Metastatic disease; Mifamurtide; Osteosarcoma; Outcome; Prognostic factors; Systemic treatment