• Kourosh Zarghooni, Grischa Bratke, Pablo Landgraf, Thorsten Simon, David Maintz, and Peer Eysel.
• Department of Orthopedics and Trauma Surgery, Helios Hospital Hildesheim, Germany; Department of Orthopedics and Trauma Surgery, University Hospital Cologne, Germany; Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Germany; Department of Pediatric Oncology, University Hospital Cologne, Germany.
• Dtsch Arztebl Int. 2023 Jun 16; 120 (24): 405412405-412.

BackgroundOsteosarcoma and Ewing's sarcoma in children and adolescents require age-specific interdisciplinary diagnosis and treatment to achieve optimal therapeutic outcomes.MethodsThe diagnosis and treatment of malignant bone tumors in childhood and adolescence are presented in the light of publications retrieved by a selective search, pertinent guidelines, and the authors' extensive experience in an interdisciplinary cancer center.ResultsBone sarcomas make up approximately 5% of all malignancies in children and adolescents; the most common types are Ewing's sarcoma and osteosarcoma. Patients are often not referred to a specialized center until long after the onset of symptoms, as they and their physicians rarely consider the possibility of a bone tumor, and the symptoms are often trivialized. Bone pain of unknown origin, swelling, and functional limitations should be investigated with conventional x-rays. Lesions of unclear origin should be biopsied after a meticulous clinical and radiologic evaluation. Multimodal treatment consists of neo - adjuvant chemotherapy, limb-preserving resection if possible, and radiotherapy where indicated. In multicenter studies, patients with osteosarcoma achieve event-free survival in 64% of cases if their disease is localized, and 28% if it is metastatic; the corresponding figures for patients with Ewing's sarcoma are 80% and 27%, respectively.ConclusionWith implementation of the current treatment recommendations, most children and adolescents with malignant bone tumors can be treated successfully with curative intent. These patients should be referred to a sarcoma center for diagnosis and treatment.

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