XXXX : a multidisciplinary approach to diagnosis and treatment.

@entity1 @entity66 @entity174 @entity5 @entity4 @entity75 @entity3808 @entity79 @entity421 @entity158
The treatment of @entity421 requires a multidisciplinary approach involving the family physician, orthopedic oncologist, medical oncologist, radiologist and pathologist. @entity421 is a mesenchymally derived, high-grade @entity79 . It is the third most common @entity5 in @entity1 and adolescents. The most frequent sites of origin are the distal femur, proximal tibia and proximal humerus. @entity1 typically present with @entity158 , @entity4 , localized enlargement of the extremity and, occasionally, pathologic @entity174 . Most @entity1 present with @entity66 . Radiographs commonly demonstrate a mixed @entity3808 and @entity75 arising in the metaphyseal region of the involved bone. Computed tomography and bone scanning are recommended to detect pulmonary and bone metastases, respectively. Before 1970, @entity421 were treated with amputation. Survival was poor: 80 percent of @entity1 died from metastatic disease. With the development of induction and adjuvant chemotherapy protocols, advances in surgical techniques and improvements in radiologic staging studies, 90 to 95 percent of @entity1 with @entity421 can now be treated with limb-sparing resection and reconstruction. Long-term survival and cure rates have increased to between 60 and 80 percent in @entity1 with @entity66 .
