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Biology and Therapeutic Advances for Pediatric Osteosarcoma

^a Department of Pediatrics, Division of Hematology-Oncology, Stanford University Medical Center, Stanford, California, USA; ^b Department of Orthopedic Surgery, Children’s Hospital, Boston, Massachusetts, USA; ^c Department of Pathology, Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA; ^d Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

Correspondence: Neyssa Marina, M.D., Stanford University Medical Center, 300 Pasteur Drive, Room G313, Stanford, California 94305-5208, USA. Telephone: 650-723-5535; Fax: 650-723-5231; e-mail: Neyssa.marina{at}stanford.edu

Osteosarcoma is the most common malignant bone tumor in children and adolescents. Survival for these patients was poor with the use of surgery and/or radiotherapy. The introduction of multi-agent chemotherapy dramatically improved the outcome for these patients and the majority of modern series report 3-year disease-free survival of 60%–70%. This paper describes current strategies for treating patients with osteosarcoma as well as review of the clinical features, radiologic and diagnostic work-up, and pathology. The authors review the state of the art management for patients with osteosarcoma in North America and Europe including the use of limb-salvage procedures and reconstruction as well as discuss the etiologic and biologic factors associated with tumor development. Therapy-related sequelae and future directions in the biology and therapy for these patients are also discussed.

Key Words. Pediatric osteosarcoma • Therapy • Biology • Multidisciplinary treatment • Therapeutic advances

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