What Is the Survival Rate for Osteosarcoma
Survival rates for osteosarcoma range between 60%-80%

The 5-year survival rate for osteosarcoma ranges between 60%-80%. Long-term survival rates are higher if cancer has not spread to the lungs (pulmonary metastasis). If the tumor has spread to the lungs, the 5-year survival rate drops to 10%. 

Stage IV osteosarcoma is more challenging to treat. However, this cancer can occasionally be treated if the metastatic tumors are removed surgically, especially if chemotherapy is administered. Only the occurrence of a pathologic fracture and primary metastases at the time of presentation have been reported to influence the outcome.

Table. 5-year relative survival rates according to SEER (Surveillance, Epidemiology, and End Results) staging
SEER stage 5-year relative survival rate
Localized 74%
Regional 66%
Distant 27%
All SEER stages combined 60%

What factors affect survival rates for osteosarcoma?

Every year, about 1,000 new cases are reported in the United States, almost half of which are in children and adolescents. With effective treatment, however, there is still a possibility of a cure. As with any cancer, early diagnosis and treatment can improve survival rates

Survival rates for osteosarcoma vary depending on various factors, including:

  • Location of the tumor
  • Size of the tumor
  • Stage of cancer
  • Age
  • Gender
  • Underlying medical conditions
  • Response to treatment

What is osteosarcoma?

Osteosarcoma or pediatric bone cancer is the most common type of bone cancer

People of any age can develop osteosarcoma (which is a rare bone disorder) although young children are mostly affected. Constant bone pain, growths, and edema are common in people with osteosarcoma. Anyone experiencing symptoms that could be associated with osteosarcoma should see a doctor for proper evaluation.

How is osteosarcoma graded and staged?

Because osteosarcoma arises from osteoblasts, which are the cells responsible for bone development, symptoms of osteosarcoma are most common in teens who are going through a growth spurt during puberty. Stages of osteosarcoma depend on the grade of the tumor.

Grades

Osteosarcoma grading is done to determine how quickly cancer cells are growing:

  • Low-grade tumor cells develop slowly and are less likely to spread to other areas of the body
  • High-grade tumor cells grow quickly and are more likely to spread to the lungs and other parts of the body

Stages

Osteosarcoma tumors are staged to determine the origin of the tumor, size, growth, and whether it affects other regions of the body:

  • Localized: The tumor is low-grade and has not yet spread; it is still confined to the area of origin and the tissues around it.
  • Metastatic: The tumor has spread to other organs, usually the lungs and other bones.
  • Recurrent: The tumor has returned or relapsed during or after treatment. Most of the time, it returns to the lungs and bones, necessitating restaging protocol.

Understanding the grade and stage of osteosarcoma helps doctors to select the best course of treatment for each person. It allows them to determine the prognosis and likelihood of recovery.

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What are the treatment options for osteosarcoma?

Osteosarcoma is typically treated with a combination of methods that may include surgery, chemotherapy, and radiation therapy

Surgery is the most common treatment option. Most people with high-grade cancer undergo three months of chemotherapy (called neoadjuvant treatment) before surgery.

Surgery

The goal of surgery is to remove all cancer cells. However, surgery planning takes into consideration how the procedure will affect your ability to go about your daily life. The extent of surgery for osteosarcoma is determined by several factors, including the size and location of the tumor.

  • Limb-sparing surgery (removes only the tumor)
    • Most osteosarcoma surgeries can be performed in a way that completely removes the cancer cells while sparing the limbs and preserving their function.
    • How much muscle and tissue must be removed and the extent of cancer spread will determine whether this procedure is an option.
    • The surgeon will rebuild the bone if a portion of it is removed. Options include bone grafts or metal prosthetics.
  • Amputation (removes the affected limb)
    • The need for amputation, which involves cutting off a limb or part of a limb, has decreased significantly due to advancements in limb-sparing surgery.
    • If amputation is required, prosthetic joint improvements can greatly enhance results and function.
  • Rotationplasty (removes the lower portion of the leg)
    • The surgeon removes the knee joint and surrounding tissue. Occasionally, this is performed on growing children.
    • The ankle then serves as a knee as the foot and ankle are rotated. For the foot and lower leg, prosthetic devices are used.
    • Results typically give the person the ability to function normally in daily life and physical activities.

Chemotherapy

  • Chemotherapy involves using drugs designed to kill cancer cells. The typical chemotherapy regimen consists of two or more medications administered orally, intravenously, or both.
  • Chemotherapy is often advised before surgery for osteosarcoma (neoadjuvant therapy). To determine the best course of treatment, doctors keep track of how chemotherapy affects cancer cells.
  • Amputation-preserving surgery may be an option if chemotherapy is able to shrink the cancer cells.
  • If the osteosarcoma does not improve after treatment, cancer may be very aggressive. To ensure that the cancer cells are removed completely, doctors may advise a different combination of chemotherapy drugs or suggest a more aggressive surgical procedure.
  • After surgery, chemotherapy can be used to eliminate any cancer cells that may be remaining.
  • Chemotherapy may be recommended if the osteosarcoma recurs after surgery or spreads to other parts of the body.

Radiation therapy

  • High-energy beams, such as X-rays and protons, are used in radiation therapy to kill cancer cells. 
  • When surgery is not an option or surgeons cannot completely remove cancer during surgery, radiation therapy may be an option.
  • To reduce the chance of damaging the surrounding healthy cells, the beams focus on the cells containing osteosarcoma.

Targeted therapy

  • Targeted therapy involves locating and eliminating cancer cells without harming healthy or normal cells.
  • Numerous studies are underway to investigate targeted therapies as a treatment for primary bone cancer. They are beneficial in situations where chemotherapy has not been effective.

Clinical trials

  • Clinical trials are studies that investigate new ways to treat cancer. 
  • Consult your doctor to see if you are eligible to participate in a clinical trial.

Rehabilitation

  • Rehabilitation is a vital part of osteosarcoma treatment and involves physical and occupational treatments, as well as socialization assistance.
  • Physical and occupational therapists will strive to help you improve mobility following surgery, and your physician will discuss what types of lifestyle changes are required.
  • Some cases of osteosarcoma require the partial or total amputation of the affected arm or leg. Most hospitals provide each person with a custom-made prosthesis, and physical therapists help you to learn to use them.

Supportive care

  • Supportive care can help prevent and manage problems such as adverse effects of medications and infections.
  • The objective is to keep you comfortable while you undergo various treatments. It is crucial to prevent immediate and long-term side effects of cancer therapy.
  • You may benefit from the care of a counselor, medical social worker, psychologist, or other mental health specialists, who can help you obtain emotional and social support.
  • You can also find support services online, such as the American Cancer Society.

What are the complications of osteosarcoma treatment?

Every treatment option has potential complications. Recurrence can also occur, usually within 18 months of treatment.

Osteosarcoma requires vigorous treatment, which can have serious adverse effects. As you receive treatment, your doctor will help you manage side effects and provide you with guidance in managing them in the years following therapy.

  • Amputation of limbs: If you have undergone surgery to amputate a limb, it will take time and patience to learn how to use a prosthetic limb. Experts can help you adapt to the change.
  • Metastasis: Osteosarcoma has the potential to spread from the initial site to other areas, making therapy and rehabilitation more difficult. 

The prognosis for osteosarcoma is good if the condition is identified and treated in the early stages. Treatment options have greatly improved over the past few decades, and more research is underway to further improve the therapies for osteosarcoma.

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Medically Reviewed on 11/11/2022
References
Image Source: iStock image

Osteosarcoma. https://www.ncbi.nlm.nih.gov/books/NBK549868/

Osteosarcoma. https://orthoinfo.aaos.org/en/diseases--conditions/osteosarcoma/

Survival Rates for Osteosarcoma. https://www.cancer.org/cancer/osteosarcoma/detection-diagnosis-staging/survival-rates.html

Osteosarcoma (Conventional). https://tumorsurgery.org/tumor-education/bone-tumors/types-of-bone-tumors/osteosarcoma-conventional.aspx