Sarcomas of bone

Abstract

Sarcomas of bone have a number of distinguishing features that set them apart from primary cancers of many other organ systems. First, they are extremely rare in comparison with other types of cancer, a fact that has impeded the ability of treatment in this field to evolve rapidly in an evidence-based manner because of the small numbers of patients available for studies. Progress in this field has been possible only with multicenter and oncology group trials that can provide sufficient numbers of patients for study. Even so, clinical trials are generally limited to prospective case series at best, and much of the literature is based on retrospective case series. True controlled randomized prospective trials are extremely rare. Nevertheless, a number of clinically useful observations defining the behavior of these tumors and their responses to treatments have derived from the analyses of the numerous case series that have been published, and these results and the associated levels of evidence are reviewed here. © 2006 Springer Science+Business Media, Inc.