Treatment of Low-Grade Central Osteosarcoma and Parosteal Osteosarcoma

Clinical Scenario

Low-grade central osteosarcoma and parosteal osteosarcoma are distinct bone malignancies. Low-grade central osteosarcoma arises within the medullary canal, while parosteal osteosarcoma originates from the bone surface. Both are characterised by a low metastatic potential, setting them apart from conventional high-grade osteosarcoma and directly shaping their management.

Treatment Approach

Given their low metastatic potential, surgery is the cornerstone of treatment for both low-grade central and parosteal osteosarcoma. The situation changes, however, when histological evaluation identifies a high-grade component — in such cases, the management approach may extend beyond surgery alone.

When a High-Grade Component Is Present

For cases in which a high-grade component is identified, chemotherapy may be considered as part of the treatment plan. The full evidence-based regimen — including agent selection, sequencing, and decision criteria — is available in the structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

Low-grade central osteosarcoma and parosteal osteosarcoma are low-grade malignancies, arising intramedullary and from the bone surface, respectively.

Low-grade central and parosteal osteosarcoma are malignancies with a low metastatic potential that should be treated by surgery alone [IV, B].

The use of ChT could be considered for cases with a high-grade component [V, C].

DOI: 10.1016/j.annonc.2021.08.1995

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