Osteosarcoma

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Stages

Stages describe how far osteosarcoma has spread and help the healthcare team plan treatment. For treatment decisions, osteosarcoma often is grouped by whether it is limited to where it started or has spread to other parts of the body.

To find out whether osteosarcoma has spread, the healthcare team uses imaging such as MRI of the primary tumor, a CT scan of your chest and a PET scan. Sometimes a bone scan also may be included.

For treatment decisions, these groups include:

  • Localized osteosarcoma. The cancer has not spread to a distant part of your body. It is limited to the bone where it started, although some nearby areas in the same bone may be included if they can be removed with the primary tumor. Treatment for localized osteosarcoma depends in part on the tumor grade. High-grade localized osteosarcoma usually is treated with chemotherapy and surgery.
  • Metastatic osteosarcoma. The cancer has spread to another part of your body. Your lungs are the most common site of spread. Osteosarcoma also can spread to other bones. Treatment may include chemotherapy plus surgery to remove the main tumor and any areas of spread that can be removed safely.

Whether cancer has spread is one of the most important factors that affects outlook.

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Diagnosis & treatmentSurvival rates
Sept. 18, 2026

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  2. Osteosarcoma and undifferentiated pleomorphic sarcoma of bone treatment (PDQ) — Health professional version. National Cancer Institute. https://www.cancer.gov/types/bone/hp/osteosarcoma-treatment-pdq. Accessed Sept. 8, 2026.
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  7. Bone cancer. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1418. Accessed Sept. 8, 2026.
  8. Ferrari C, et al. Osteosarcoma and Ewing sarcoma of bone: An Italian mono-institutional epidemiological study. Diagnostics. 2025; doi:10.3390/diagnostics15030328.
  9. NCCN member institutions. National Comprehensive Cancer Network. https://www.nccn.org/home/member-institutions. Accessed Sept. 10, 2026.
  10. Osteogenic sarcoma. NCI Dictionary of Cancer Terms. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/osteogenic-sarcoma. Accessed Sept. 8, 2026.
  11. Niederhuber JE, et al., eds. Sarcomas of bone. In: Abeloff's Clinical Oncology. 6th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Sept. 9, 2026.
  12. COG member institutions. Children’s Oncology Group. https://childrensoncologygroup.org/patients-families/member-institutions/. Accessed Sept. 10, 2026.
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