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Related Concept Videos

Tumor Progression02:07

Tumor Progression

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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
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Bone Disorders01:29

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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
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The Tumor Microenvironment02:17

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Every normal cell or tissue is embedded in a complex local environment called stroma, consisting of different cell types, a basal membrane, and blood vessels. As normal cells mutate and develop into cancer cells, their local environment also changes to allow cancer progression. The tumor microenvironment (TME) consists of a complex cellular matrix of stromal cells and the developing tumor. The cross-talk between cancer cells and surrounding stromal cells is critical to disrupt normal tissue...
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Bone Formation by Endochondral Ossification01:24

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Bone formation, or ossification, begins around the sixth to seventh week of embryonic development. Most bones develop from a cartilaginous template through the process of endochondral ossification. Cartilage formation begins when clusters of mesenchymal cells differentiate into chondrocytes. These chondrocytes proliferate rapidly and secrete an extracellular matrix that becomes encased in a membrane called the perichondrium. The resulting cartilage model provides a template that resembles the...
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Osteoclasts in Bone Remodeling01:31

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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
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Treatment Resistant Cancers

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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Related Experiment Video

Updated: Oct 17, 2025

Three-Dimensional Bone Extracellular Matrix Model for Osteosarcoma
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Osteosarcoma: An Evolving Understanding of a Complex Disease.

John H Alexander1, Odion T Binitie, G Douglas Letson

  • 1From the Sarcoma Department, Moffitt Cancer Center, Tampa, FL (Alexander, Binitie, Letson, and Joyce), and the Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH (Alexander).

The Journal of the American Academy of Orthopaedic Surgeons
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Summary

Osteosarcoma treatment combines chemotherapy and surgery for localized disease, achieving 80% survival. Metastatic osteosarcoma survival remains poor, highlighting the need for improved treatment strategies.

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Area of Science:

  • Orthopedic Oncology
  • Pediatric Oncology
  • Medical Oncology

Background:

  • Osteosarcoma is the most common primary bone cancer in children and adults.
  • Current treatment for localized disease involves neoadjuvant chemotherapy, surgery, and adjuvant chemotherapy, yielding up to 80% 5-year survival.
  • Survival rates for metastatic osteosarcoma remain poor, indicating a significant unmet clinical need.

Purpose of the Study:

  • To review the current treatment landscape for osteosarcoma.
  • To highlight recent advances in understanding molecular drivers and surgical techniques.
  • To outline future directions for improving osteosarcoma patient outcomes.

Main Methods:

  • Review of current neoadjuvant chemotherapy, surgical resection, and adjuvant chemotherapy protocols.
  • Analysis of advances in molecular understanding, risk stratification, and collaborative trials.
  • Evaluation of surgical innovations including computer navigation and implant design.

Main Results:

  • Multimodal therapy offers up to 80% 5-year survival for localized/oligometastatic osteosarcoma.
  • Significant progress has been made in understanding disease biology and surgical techniques.
  • Surgical advances improve functional outcomes without compromising oncologic results.

Conclusions:

  • Osteosarcoma remains a challenging malignancy, particularly in its metastatic form.
  • Future research should focus on risk stratification to minimize toxicity and improve survival.
  • Continued innovation in reconstructive surgery is crucial for enhancing patient quality of life.