The treatment of osteosarcoma forms the basis of therapy for most other sarcomas. The concepts that were developed originally for the staging, pathologic analysis, chemotherapy, and surgical management of osteosarcoma have now been applied to many other diseases. Most cases of osteosarcoma are classified as conventional osteosarcoma, which is a high-grade tumor arising typically in an adolescent patient or young adult. For these patients, the standard treatment consists of preoperative chemotherapy, wide surgical excision, careful pathologic mapping of the resected tumor, and postoperative chemotherapy based upon the percentage of necrosis of the tumor. There are many uncommon variants of osteosarcoma that behave differently than conventional osteosarcoma. Osteosarcoma of the craniofacial bones resembles conventional osteosarcoma histologically, but its prognosis is different since metastasis is uncommon. Other variants discussed in this chapter have distinctive radiographic, histologic, or demographic characteristics. Secondary osteosarcoma, which arises in a preexisting bone lesion, has a markedly worse prognosis than other forms of osteosarcoma.
KeywordsNational Comprehensive Cancer Network Postoperative Chemotherapy Malignant Fibrous Histiocytoma Craniofacial Bone Parosteal Osteosarcoma
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