Surgery in malignant bone tumors

Limb preservation is now the standard method of treatment for most bone sarcomas. Limb-salvage operations have been shown to have similar recurrence rates to amputation. A recent study by Schrager et al. of pediatric patients with ES and OS showed a 35% greater mortality rate with amputation compared with limb salvage. The success of limb salvage is the result of several advances in the evaluation, diagnosis, and treatment of pediatric bone sarcomas. These include imaging modalities such as magnetic resonance imaging that allow for precise mapping of the tumor, effective chemotherapy, and reconstructive options that allow for a functional limb. Treatment typically includes preoperative chemotherapy, surgical resection with or without reconstruction, and postoperative chemotherapy.