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Stages of osteosarcoma:

• Once osteosarcoma has been found, more tests may be done to find out if
cancer cells have spread to other parts of the body. This is called staging.
• At present, there is no staging system for osteosarcoma.
• Instead, most patients are grouped depending on whether cancer is found
in only one part of the body (localized disease) or whether the cancer has
spread from one part of the body to another (metastatic disease).
• The following groups are used for osteosarcoma:

1. Localized osteosarcoma
 The cancer cells have not spread beyond the bone or nearby tissue in
which the cancer began.
2. Metastatic osteosarcoma
 The cancer cells have spread from the bone in which the cancer began to
other parts of the body. The cancer most often spreads to the lungs. It may
also spread to other bones.
 In multifocal osteosarcoma, tumors appear in 2 or more bones, but have
not spread to the lungs.
3. Recurrent
 Recurrent disease means that the cancer has come back (recurred) after
it has been treated. It may come back in the tissues where it first started or
it may come back in another
part of the body. Osteosarcoma most often recurs in the lung. When
osteosarcoma recurs, it is usually within 2 to 3 years after treatment is
completed. Later recurrence is possible, but rare.
Different types of osteosarcoma

There are many different types of osteosarcoma that are quite different in
natural history and their potential for lethal growth. The “grade” is a term
used to indicate the level of aggressive growth and potential for
metastasis, usually based upon the appearance of the tumor under
microscopic analysis.

1. Classical or conventional high grade central type

 which accounts for 90% of all osteosarcomas.
 By far the most common osteosarcoma.

2. Telangiectatic

3. Small cell

4. Secondary (associated with another pre-existing disease such as Paget’s

disease or prior radiation exposure)

There are low grade types of osteosarcoma too.
5. Surface or juxtacortical low grade osteosarcoma
 also known by the names periosteal osteosarcoma

6. Low grade central osteosarcoma