Abstract
Background: More than 20 years ago, the advent of a multidisciplinary approach that combined multi-agent chemotherapy and limb-sparing surgery greatly improved the survival rate of patients with osteosarcoma. Unfortunately, since that time, survival rates have not dramatically improved. Approximately 20% of patients who do not present with metastases at diagnosis will not survive. This group of patients appears to be resistant to current treatment as attempts to intensify therapy after surgery for patients with a poor histopathologic response have not significantly improved survival rates. It is these patients who are in the greatest need of extra clinically relevant markers for prognosis and who can be most helped by molecular analysis. Objective/method: This literature review gives an overview of current research and clinical advances related to osteosarcoma biomarkers. Conclusion: Although steady progress has been made in the identification of genetic alterations in osteosarcoma, no individual molecular marker has thus far been demonstrated to have a better prognostic significance in the treatment of osteosarcomas than the current clinical markers. Thus, there is clearly a need to use new comprehensive analysis technologies to develop significantly more informative classification systems and to identify new therapeutic targets.