What are the NCCN and ESMO treatment guidelines for metastatic osteosarcoma at presentation?

Updated: Dec 04, 2018
  • Author: Charles T Mehlman, DO, MPH; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Answer

NCCN treatment recommendations for metastatic disease at presentation include the following [30] :

  • Enrollment in a clinical trial should be considered when available; in addition, whenever possible patients should be referred to a tertiary care center with expertise in sarcoma, for treatment by a multidisciplinary team
  • For resectable metastatic disease (pulmonary, visceral or skeletal), preoperative chemotherapy followed by wide excision of primary tumor; chemotherapy and metastasectomy is also a treatment option
  • For unresectable metastatic disease, chemotherapy with or without radiation therapy; reassess primary site for local control
  • ESMO-PaedCan-EURACAN recommends that primary metastatic osteosarcoma be treated with a curative intent, following the principles of non-metastatic osteosarcomas [31]

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