Two Onc Docs Bone Sarcomas 2025 UPDATE
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Sep 15, 2025 Dive into the intricate world of bone sarcomas as the hosts break down vital topics like diagnosis, staging, and treatment strategies. Explore the unique characteristics of osteosarcoma and Ewing's sarcoma, highlighting the importance of personalized therapies. Discover how genetic mutations influence treatment plans and the critical role of surgical interventions. With a focus on the latest chemotherapy protocols and emerging systemic treatments, this discussion sheds light on a challenging yet fascinating area of oncology.
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Osteosarcoma Presents And Is Staged Distinctly
- Osteosarcoma is the most common bone sarcoma with a bimodal age distribution peaking at 10–20 and 60–80 years.
- Diagnosis uses X-ray features like sunburst pattern and Codman's triangle plus core biopsy and MRI/CT or PET for staging.
Necrosis After Chemo Predicts Outcome
- Prognosis for osteosarcoma hinges on tumor grade and size, and critically on chemo response.
- ≥90% necrosis on surgical pathology predicts the best relapse-free survival.
Chemo Before Surgery For High-Grade Osteosarcoma
- For high-grade osteosarcoma, start neoadjuvant chemotherapy then operate, then finish adjuvant chemo.
- Use doxorubicin plus cisplatin (± high-dose methotrexate in younger patients) and do not switch regimen based solely on <90% necrosis.