Advanced Treatment Sarcoma Options

Sarcomas are bone and soft tissue cancers – which impact connective tissue (tendons) and muscles – and are a rare condition in children. They account for less than 3,000 new cases annually in the US., and account for approximately 11% of all tumors.

Advances in imaging and chemotherapy have dramatically increased the long-term survival of sarcoma patients. MRI has improved our ability to see the tumor and evaluate its response to chemotherapy. Chemotherapy and radiotherapy have resulted in an increased survival rate.

With preoperative chemotherapy and surgery the five-year survival rate for osteosarcoma and Ewing's sarcoma approaches 70 to 80%. Genetic advancements are still evolving, and will likely play a significant role in treatment in the near future.

Diagnosis

The doctor will use X-rays and a MRI of the entire area, including the joint above and below the tumor. They may recommend a CT scan of the chest to view if there if there is cancer (metastatic lesions) or perform a bone scan to identify other conditions (skip lesions or other bony metastases). Your child may need a bone marrow biopsy to determine if there is soft tissue and Ewing’s sarcoma.

Surgical options

If a surgical amputation is necessary, Children’s Healthcare of Atlanta doctors can provide many reconstruction options. Before any surgery is performed, your doctor will carefully explain and help you plan the best course for your child.

We will help you compare location, type, and surgical procedures. Our team of specialists will care for your child, including radiologists, pediatric pathologists, oncologists, prosthetists, physical therapists, social workers and surgeons.

Your child will have several options when it comes to tumor resection. This will depend on the tumor type, location, spread to other regions (metastasis), and response to chemotherapy. There are three main options: limb sparing, amputation or rotationplasty.

Amputation

Amputation is a surgical procedure performed to eliminate a diseased portion of the extremity.

Limb-sparing surgery

Limb-sparing surgery is a procedure to keep a child's extremities. During the procedure only the malignant tumor tissue is removed. The resected portion of tissue and bone is replaced by metallic (prosthesis) or bone transplants (allograft). If your child is under the age of 10, he may be a candidate for a growing prosthesis.

Rotationplasty

Rotationplasty removes a portion of the limb. The lower portion of the leg is then rotated 180° and reattached. The ankle will act like a knee joint, providing extra function, more mobility and better control with a prosthesis.

Read more about rotationplasty

Is my child a candidate for limb sparing?

The first step to identify if your child is a candidate for limb sparing surgery is a biopsy, a piece of tissue is removed to diagnose his condition. The next step is staging, where the extent and/or spread of the tumor is identified. Sophisticated radiographic technology is used in staging. Your surgeon will then decide if the tumor can safely be removed in its entirety without compromising the overall integrity of the limb. Tumors that are too close to a major nerve or artery may not be a candidate limb sparing. If not, an amputation or rotationplasty may be recommended.

Who will take care of my child?

The oncologic rehabilitation program provides care specific to the pediatric patient. A team of specialists will help ensure the best possible outcome for your child. You and your family will work with a team to achieve a common goal.

Your child will be introduced to other patients and families who have undergone a similar procedure, to aid in your decision making. We are here to help. Our team will work with you to find the treatment path that is right for your child.