Abstract
Osteosarcoma (OS) is the most common malignant tumour of the skeleton accounting for approximately 35 % of primary bone tumours. Successful treatment of osteosarcoma requires a close cooperation between the specialists of a multidisciplinary team consisting of an oncologist, surgeon, pathologist and radiologist.
The best care is provided by specialized centres with appropriate experience in which comprehensive care is available. The therapeutic regimen must include radical removal of the primary tumour and/or metastases in combination with systemic chemotherapy.
The cytostatic drugs primarily used include doxorubicin, high-dose methotrexate, cisplatin and ifosfamide. The goal of dividing chemotherapy into preoperative and postoperative parts is a reduction in the tumour mass and improved delineation of the tumour from the surrounding structures.
This improves the surgical radicality with the affected part of the skeleton being replaced without the need for a mutilating procedure. Also of importance is the knowledge of the histopathological response to preoperative chemotherapy which affects the intensity of postoperative treatment.
The management of metastatic disease and possible recurrence has not been addressed adequately as yet. Improved results can be expected with the introduction of novel therapeutic agents and modalities.