Assessment and management of childhood skeletal malignancies

Primary bone cancers are a rare but life changing diagnosis. Early diagnosis and onward referral to a multidisciplinary team within a dedicated sarcoma centre is associated with the best outcomes. The most common lesions, osteosarcoma and Ewing's sarcoma, are aggressive tumours with a tendency to metastasize to the lungs. Treatment for localized and some metastatic cases generally consists of multi-agent neoadjuvant chemotherapy followed by surgical resection and reconstruction prior to further chemotherapy. In spite of advances in surgical technique and chemotherapy regimes, overall five-year survival remains approximately 50-60%.