Interdisciplinary diagnostic and treatment of bone sarcomas of the extremities and trunk

Contrary to the relatively common benign bone tumours and tumour-like lesions, bone sarcomas are rare malignancies with an incidence of 0.8 new cases per 100 000 persons per year. The most common primary malignant bone tumour is osteosarcoma, followed by chondrosarcoma and Ewing sarcoma. Osteosarcomas and Ewing sarcomas occur predominantly in children, adolescents and young adults, while chondrosarcomas primarily affect older patients. Most of the tumours are located in the extremities and the pelvis and in about 90% of the cases the surgical treatment can be performed by means of a limb-sparing wide resection. An endoprosthetic or biological reconstruction of the resulting defect, depending on several patient- und tumour-related factors, is usually necessary. Apart from the surgical treatment, patients with osteosarcoma and Ewing sarcoma require a pre- and postoperative chemotherapy, while Ewing sarcoma patients often undergo radiation therapy as well. Regular follow-up examinations are required after the completion of treatment for the early detection and management of local and/or systemic recurrences as well as treatment-related complications. An extensive experience in the clinical and imaging features as well as the interdisciplinary treatment of these tumours is necessary for optimal patient care. Without it mistakes are often made, which can have grave consequences on the patients' prognosis and functional outcome. The centralised treatment of these patients in specialised sarcoma centres is therefore recommended.