[Surgical treatment of primary malignant bone tumors : Local therapeutic considerations with respect to extent of resection and reconstruction in a multimodal treatment concept].

The modern treatment of primary bone sarcomas is integrated into a multimodal treatment concept consisting of systemic and local therapeutic modalities. Conventional chemotherapy plays the leading role in first line treatment. In terms of local treatment of the primary tumor, complete tumor removal (R0 resection) is the procedure of choice in a curative treatment concept. In Ewing's sarcoma, additive local radiotherapy must be taken into account in the surgical planning as well as the choice of reconstruction procedure. In a palliative treatment approach, an individual treatment adaptation must be made. Depending on the tumor site and individual parameters, different reconstruction procedures are available. The quality of tumor removal directly influences the local recurrence rate, overall prognosis and type of reconstruction. Due to the rarity of the disease and the necessary high degree of specialization of the disciplines involved, treatment of bone sarcomas is restricted to specialized centers.