Childhood cancers: osteosarcoma

Osteosarcomas are highly aggressive cancers that develop from a bone. They occur mainly in young people between the ages of 10 and 20.

The majority of cases of osteosarcoma occur in the knee, at the lower end of the femur or upper end of the tibia. Other locations are possible, usually on a long bone (humerus, fibula, etc.). The most common location for metastases is the lung, followed by the other bones. Metastatic forms of the disease are more difficult to treat. 


Different stages of treatment for osteosarcoma

Whether localized or metastatic, osteosarcoma is most frequently treated by first-line chemotherapy. If it is effective, it helps reduce the tumor bases enough to allow for surgery.

In the localized forms, conservative surgical treatment is then offered to the vast majority of patients. This allows the tumor to be fully excised, and the affected limb can be reconstructed. The choice of reconstruction techniques varies according to the site of the bone affected, the possibility of preserving the joint and the age of the child (maintaining growth potential). Post-operative chemotherapy is performed.

For young patients with metastatic osteosarcoma, the treatment regimen is identical, with surgical treatment as soon as possible of the metastases, which are most frequently in the lungs and/or the bone.

If recurrence occurs, generally in the early years following the diagnosis, surgical removal is performed, sometimes in conjunction with chemotherapy.


The research goes on to refine the diagnosis of osteosarcoma

There is currently little diagnostic information to allow the treatment to be adapted, but a number of studies are underway on the search for markers to refine the diagnosis.

At the same time, new treatments are starting to emerge, and clinical trials are continuing in order to assess their benefit.