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Devita's Cancer Principles

Malignant tumors arising from the skeletal system are rare, representing just 0.001% of all new cancers. Only 400 to 600 new primary bone sarcomas are diagnosed annually in the United States. Osteosarcoma and Ewing’s sarcoma, the two most common bone tumors, occur mainly during childhood and adolescence (Fig. 45.2.1). Other mesenchymal (spindle cell) neoplasms that characteristically arise after skeletal maturity— fibrosarcoma, chondrosarcoma, and malignant fibrous histiocytoma (MFH)—are less common. The vast majority of experience reported in the management of bone neoplasms has been obtained in patients with osteosarcomas. As a result, the surgical, chemotherapeutic, and radiotherapeutic principles developed for treatment of osteosarcomas form the basis of the management strategy for most of the spindle cell neoplasms.

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