Introduction
Primary tumors arising in bone are characterized by an almost unique age incidence pattern, incompletely understood biology, complex and morbid treatments and patient outcomes in need of improvement. In the adolescent and young adult (AYA) age range, the two most common bone sarcomas are osteosarcoma (OS) and Ewing sarcoma (ES) of bone. While a significant proportion of young people with these diseases can be cured, their lives are often associated with lifelong consequences, especially in, but not limited to, physical functioning, so that survivorship issues are an essential consideration in providing care for AYA with bone sarcoma. Achieving improvements in survival has proved challenging despite greater levels of international collaboration in recent decades. This is likely multifactorial, including unequal access to expert multidisciplinary care. Recent observations of activity of new systemic agents against advanced disease hold hope for the future. A well-established multi-modality treatment approach for OS and ES focuses on systemic chemotherapy integrated with management of the primary tumor by surgery, radiotherapy (RT) or both. The challenge for specialists is to optimize these treatments to ensure the greatest number of young people survive with least long-term cost.