Osteosarcoma

Osteosarcoma is a malignant bone cancer; together with Ewing's sarcoma it accounts for most primary bone malignancies. There is a preference for the metaphyseal region of tubular long bones. 50% of cases occur around the knee. It is a malignant connective (soft) tissue tumor whose neoplastic cells present osteoblastic differentiation and form tumoral bone.

Prognosis

Prognosis is separted into three groups.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Stage I osteosarcoma has a good prognosis(>90%) and just requires surgery.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Stage IIb prognosis depends on the site of the tumor(proximal tibia, femur, pelvis, etc.) size of the tumor mass(in cm.), the degree of necrosis from neoadjuvant chemotherapy(beforeoperation chemotherapy), and pathological factors like the degree of p-glycoprotein, whether your tumor is CXCR4 positive, Her2 positive as these can lead to distant metastases to the lung. Longer time to metastases, more than 12 months or 24 months and the number of metastases and resectability of them lead to the best prognosis with metastatic osteosarcoma. It is better to have fewer metastases than longer time to metastases. Those with a longer length of time(>24months) and few nodules(2 or fewer) have the best prognosis with a 2-year survival after the metastases of 50% 5-year of 40% and 10 year 20%. If metastases are both local and regional the prognosis is different unfortunately. (see http://www.osteosarcomasupport.org/prognosis.htm) top two articles.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Initial Presentation of stage III osteosarcoma with lung metastates depends on the resectability of the primary tumor and lung nodules, degree of necrosis of the primary tumor, and maybe the number of metastases. Overall prognosis is 30% or greater depending.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~