Bone Cancer

Epidemiology: Primary malignant bone cancers have a global incidence of less than 1%; approximately one thousand new cases are diagnosed annually in the United States [1]. Chondrosarcoma is the most prevalent in adults whereas in children and teens, osteosarcoma and Ewing sarcoma are most prevalent. The occurrence of osteosarcoma mostly impacts the age group of 10–30 years with teens being the most affected. Only 10% of the osteosarcoma cases are identified in people of age > 60 years. The bimodal incidence of osteosarcoma can be observed at two peaks: a major peak at the age of 18 years (primary diagnosis) and a second peak with poor prognosis at 60 years of age [2, 3]. According to the SEER database, the 5-year survival rates of giant cell tumor of bone, chordoma, and chondrosarcoma were 76%, 79%, and 79%, respectively, for the period 2011–2017. Chondroma (66.8 months) has the highest mean survival rate followed by chondrosarcoma (63.5 months), Ewing sarcoma (58.0 months), and osteosarcoma (54.9 months) [1]. The incidence rates of osteosarcoma during 1992–2004 for American Indian/Alaska Native, Hispanic, non-Hispanic white, Black, and Asian/Pacific Islander were 2.4%, 3.3%, 3%, 4%, and 2.9%, respectively [3]. Males had a higher incidence of osteosarcoma than females [3]. In children to young adults, the median diagnostic age for Ewing sarcoma is 14–15 years [4]. The incidence of metastatic Ewing sarcoma in children (0–9 years old) and adolescents and young adults (15–19 years old) is 23.8% and 32.3%,respectively [4]. According to a retrospective study during 1973–2015, the 1-, 5-, and 10-year survival rates for Ewing sarcoma were 91.1%, 72.9%, and 68.2%, respectively [5]. Females had consistently better 1-, 5-, and 10-year survival rates for Ewing sarcoma, with rates 91.4%, 75.4%, and 71.1%, respectively, when compared to men with 90.8%, 70.3%, and 65.7%, respectively [5].