Current status of research on osteosarcoma

I believe everyone is familiar with the harmfulness of osteosarcoma. In order to improve the cure rate of this malignant tumor disease, many scholars have conducted research on the symptoms, treatment methods, and medication of osteosarcoma in recent years, and have achieved relatively great results. Now I will introduce to you the current status of osteosarcoma research.

Osteosarcoma is a malignant tumor originating from mesenchymal tissue, characterized by spindle-shaped stromal cells that can produce bone-like tissue. It is also called osteogenic sarcoma, accounting for 20% of primary malignant bone tumors and is the most common primary malignant bone tumor in adolescents. 70% to 80% of patients develop the disease at the age of 10 to 25 years old, with an annual incidence of about (1 to 3) per 1 million people. The most common sites of osteosarcoma are the metaphysis of long tubular bones, such as the distal femur, proximal tibia and proximal humerus. Osteosarcoma occurring in the spine, pelvis and sacrum is rare. The vast majority of patients have a single lesion. Patients have no typical clinical symptoms at the onset of the disease, only local pain and swelling, sometimes accompanied by joint dysfunction. Very few seek medical treatment for pathological fractures, which are easily confused with trauma or growing pains. They are highly malignant and are very likely to metastasize to the lungs in the early stages.

Osteosarcoma mostly occurs in children and adolescents, seriously threatening their health and life, and is a disaster for families and society. Therefore, it is an urgent task to improve the diagnosis and treatment of osteosarcoma as soon as possible. Before the emergence of chemotherapy in the 1970s, limb osteosarcoma was mainly treated with amputation. Patients not only suffered limb disability and huge psychological trauma, but 80% of patients still inevitably died of lung metastasis. When neoadjuvant chemotherapy appeared, the 5-year survival rate of osteosarcoma was greatly improved by the comprehensive treatment of preoperative chemotherapy, surgery and postoperative chemotherapy, from less than 20% to 50% to 60%, and more than 90% of patients with limb osteosarcoma can undergo limb-saving treatment, using different reconstruction methods to enable the retained limbs to obtain more satisfactory functions. The relatively mature treatment methods that have been studied so far include: neoadjuvant chemotherapy, limb-saving surgery, and radiotherapy.

Currently, the "bottleneck" that limits further improvement in the survival rate of osteosarcoma patients is the occurrence of osteosarcoma lung metastasis. About 15% of osteosarcoma patients have radiologically detectable lung metastases when they seek medical treatment, and 25% to 40% of patients will have radiologically detectable lung metastases during or after treatment. Therefore, more than 50% of patients may develop lung metastases.

At present, the comprehensive treatment of osteosarcoma patients is still mainly based on preoperative and postoperative chemotherapy and surgical treatment. The treatment effect has been improved compared with the past. However, the treatment of osteosarcoma has encountered bottlenecks in recent years, especially for patients with lung metastasis and chemotherapy resistance. New drugs and treatment strategies need to be developed, while immunotherapy and gene therapy are still in the exploratory stage and are rarely used in actual clinical applications. It is believed that with the progress of clinical research and application of chemotherapy resistance, gene therapy and molecular targeted therapy, new and more effective comprehensive treatment methods will be provided for osteosarcoma patients, and the cure rate of osteosarcoma will inevitably increase gradually.