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Bone Sarcomas

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International Manual of Oncology Practice

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Abstract

Osteosarcomas are uncommon, accounting for only 1 % of all cancers diagnosed annually in the United States. The incidence peaks in early adolescence and in adults aged >65 years. This cancer has a predilection for the metaphyseal region of the long bones, and localized pain that lasts for several months is the most common symptom. The histologic subtypes include osteoblastic, fibroblastic, and chondroblastic. Less common variants include Ewing’s sarcoma, small cell, telangiectatic, multifocal, and a malignant fibrous histiocytoma subtype. The staging assessment includes magnetic resonance imaging, computed tomography, bone scan, and/or positron emission tomography. It usually spreads hematogenously, and the main site of metastasis is the lung.

It is necessary to consider limb preservation in patients with localized disease. The recommended regimens for non-metastatic disease include neoadjuvant and adjuvant cisplatin plus doxorubicin-based chemotherapy. In patients aged <30 years, adding high-dose methotrexate is reasonable. The mainstay treatment is tumor resection preferably with wide margins within 12 weeks after starting chemotherapy.

In metastatic disease limited to the lungs, it is important to consider resection. Recurrence is common, indicating second-line chemotherapy regimens containing ifosfamide, etoposide, and carboplatin.

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Author information

Authors and Affiliations

  1. Department of Medical Oncology, Federal University of São Paulo, UNIFESP, Rua Pedro de Toledo, 377, CEP 04039-031, São Paulo, SP, Brazil

    Maria Cecília Monteiro Dela Vega M.D., Pedro Nazareth Aguiar Jr. M.D. & Hakaru Tadokoro M.D., Ph.D.

  2. Department Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal

    Ramon Andrade de Mello M.D., Ph.D.

  3. Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal

    Ramon Andrade de Mello M.D., Ph.D.

Authors
  1. Maria Cecília Monteiro Dela Vega M.D.
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  2. Pedro Nazareth Aguiar Jr. M.D.
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  3. Hakaru Tadokoro M.D., Ph.D.
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  4. Ramon Andrade de Mello M.D., Ph.D.
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Corresponding author

Correspondence to Ramon Andrade de Mello M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Medical Oncology, University of Algarve, Faro, Portugal

    Ramon Andrade de Mello

  2. edificio 7, ala nascente, 3º andar, University of Algarve, Dept Cie Biomed edificio 7, ala nascente, 3º andar, Faro, Portugal

    Álvaro Tavares

  3. Medical Oncology, University of Athens, Athens, Greece

    Giannis Mountzios

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Vega, M.C.M.D., Aguiar, P.N., Tadokoro, H., de Mello, R.A. (2015). Bone Sarcomas. In: de Mello, R., Tavares, Á., Mountzios, G. (eds) International Manual of Oncology Practice. Springer, Cham. https://doi.org/10.1007/978-3-319-21683-6_30

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