The potential for an improved prognosis with chemotherapy in osteogenic sarcoma

Effective chemotherapeutic agents administered shortly after definitive primary treatment to patients with osteogenic sarcoma have altered the natural history of the disease. In contrast to past experience, pulmonary metastases fail to develop in the overwhelming majority of patients receiving treatment with chemotherapy. Patients with established pulmonary metastases have also been salvaged. The therapeutic strategy advocated for different categories of patients is outlined. Although chemotherapy involves additional hospitalization and inconvenience, this additional mode of treatment appears to be the only mechanism by which a substantial improvement in survival of osteogenic sarcoma can presently be achieved.