Under the surgical direction of Dr. Saminathan Suresh Nathan, the leading Osteosarcoma Surgeon in Singapore, our protocols are defined by a unique clinical pedigree. As a fellowship-trained specialist from Memorial Sloan Kettering Cancer Center (MSKCC) and the recipient of the 2004 ORS New Investigator Recognition Award (NIRA), Nathan SS et al work in Tumor Interstitial Fluid Pressure (TIFP) (2003-2015) provides the scientific foundation for our limb salvage strategies. We manage osteosarcoma as a high-stakes engineering challenge. With unprecedented leadership in global osteosarcoma groups and more than thirty years of clinical experience, we prioritize radical oncological clearance balanced with the mechanical demands of reconstruction. By integrating neoadjuvant chemotherapy, 3D-printed custom implants, and biological grafting, we focus on restoring the structural integrity of the human frame.
Oncological Clearance: Achieving wide margins through verified 3D-planned resections.
Growth Preservation: Utilizing epiphysiodesis and expandable prostheses in pediatric cases.
Structural Integrity: Integration of megaprostheses and biological grafts for long-term functional endurance.
Making a case for the socioeconomic determinacy of survival in osteosarcoma🔗
 Treatment algorithm for locally recurrent osteosarcoma based on local disease-free interval and the presence of lung metastasis🔗
Outcome satisfaction in long-term survivors of oncologic limb salvage procedures🔗
(Last updated March 10, 2026)
Figure 1. Osteosarcoma is the archetype for management of all tumors in musculoskeletal oncology. Survival in the localised disease category is typically 70% at 5 years. Shown here is the survival curve for metastatic and non-metastatic disease which is lower than this figure.
Figure 2. Singapore has been involved in musculoskeletal oncology research for the last 40 years beginning with development of techniques in surgery (a) as this paper on vascularised joint transfers attests (Pho, 1979). Presently, we investigate molecular basis of disease as in this study recently published (Nathan SS, 2011) that suggests that micro-environmental differences inosteosarcomamay cause drug resistance (b). Present clinical research (Nathan SS, 2009) investigates the best siting of of procedures for a given problem (c). In 2012, on review (Nathan SS, 2012) of the national survival data it was conclusively determined that treatment in Singapore resulted in a superior survival rate of patients with osteosarcoma comparable to the best centres in the United States (d).
Figure 3. This boy had come to Singapore from the middle-east seeking to save his pathologically fractured osteosarcoma of the shoulder. Often in these circumstances one needs to perform an amputation. However, after very careful immobilisation of the fracture and undergoing a course of chemotherapy we were able to salvage the limb and replace the loss with a tumor prosthesis.Â