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Orthopaedic Surgery

Answer 2
  1. Wide resection and chemotherapy. Successful surgical management of osteosarcoma is achieved by obtaining wide surgical margins with limb-sparing resection. However, the presence of metastasis is the largest predictor of 5-year survival, with a 10% to 20% rate compared with 60% to 80% without evidence of metastasis.1 Preoperative and postoperative chemotherapy significantly improve outcomes for patients with osteosarcoma. Above the knee amputation is an option, but limb salvage is indicated in patients with resectable tumors. Curettage and bone grafting and wide resection alone are insufficient for tumor excision. Radiation is not as effective in tumor eradication as compared with chemotherapy.

     Gibbs CP Jr, Weber K, Scarborough MT. Malignant bone tumors. Instr Course Lect 2002;51:413-28.

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