Prognosis and survival for childhood osteosarcoma

Last medical review:

The following are prognostic and predictive factors for childhood osteosarcoma.

If the cancer has spread

Metastasis is when cancer spreads from where it started to another part of the body. Whether or not the cancer has already spread when it is first diagnosed is the most important prognostic factor for childhood osteosarcoma. Metastasis is linked with a poorer prognosis.

Osteosarcoma that has only spread to a lung has a more favourable prognosis than osteosarcoma that has spread to other bones.

Location of the tumour

Tumours farther from the centre of the body have a better prognosis than tumours closer to the centre of the body. This may be because tumours farther from the centre of the body are usually easier to remove surgically.

Tumours in the upper arms or upper legs have a better prognosis than tumours in the pelvis or spine. Tumours in the pelvis or spine tend to have the poorest prognosis. They are often detected late and are often closer to other important organs, which makes them hard to completely remove.

Size of the primary tumour

Larger tumours appear to have a poorer prognosis than smaller tumours.

Response to neoadjuvant chemotherapy

Chemotherapy is usually given before surgery to shrink the tumour and make surgery easier. This is called neoadjuvant chemotherapy. Osteosarcoma that responds well to neoadjuvant chemotherapy (more than 90% of the tumour cells are killed) has a better prognosis than osteosarcoma that does not respond to neoadjuvant chemotherapy.

Whether the tumour is completely removed

Tumours that can be completely removed have a better prognosis than tumours that can't be completely removed.

Broken bones

Tumours that cause breaks (fractures) in the bone have a poorer prognosis than tumours that have not led to broken bones.

Expert review and references

  • Abha Gupta, MD, MSc, FRCPC
  • Raveena Ramphal, MBChB, FRACP

Survival statistics for childhood osteosarcoma

Survival statistics for osteosarcoma (a type of childhood bone cancer) are very general estimates and depend on stage.