NCCN Publishes First Guidelines for Pediatric Bone Sarcoma

The National Comprehensive Cancer Network (NCCN) published the first edition of its NCCN Clinical Practice Guidelines in Oncology for Pediatric Bone Sarcoma on October 1, 2026, according to a news release from the organization.

According to NCCN, the new guidelines focus on Ewing sarcoma and other undifferentiated round cell sarcomas. The organization described Ewing sarcoma as extraordinarily rare overall but the second most common primary bone tumor in children and adolescents, typically affecting teenagers aged 15 to 19 years. The release noted that the disease can present as severe and persistent pain or swelling in the limbs or pelvis. Because those symptoms are also common to other bone issues in teenagers, NCCN identified x-rays as a key first step in diagnosis.

Citing American Cancer Society data, the release reported a 5-year survival rate of 81% for Ewing sarcoma diagnosed at an early stage, compared with 41% for metastatic disease.

Patrick Leavey, MD, of UT Southwestern Simmons Comprehensive Cancer Center, who chairs the guidelines panel, noted the importance of clinical trials for advancing new treatments. According to NCCN, the extreme rarity of the disease can make therapeutic advances difficult, although risk stratification has improved significantly in recent years. Dr. Leavey also said intensive cancer treatment can drain teenagers' energy and disrupt their developing sense of autonomy. Paula Head, a patient advocate on the panel, said that as a parent who experienced this with her daughter, she wanted guidelines specific to pediatrics "because these cancers and their treatments are different than for adults."

The new guidelines join other pediatric NCCN guidelines added in recent years, including those for pediatric acute lymphoblastic leukemia, pediatric Hodgkin lymphoma, Wilms tumor, and pediatric soft tissue sarcoma. NCCN guidelines are available free for non-commercial use at NCCN.org. Free registration is required to see the clinical content.

Source: National Comprehensive Cancer Network. A formidable type of childhood cancer gets added to highly regarded library of treatment recommendations. News release. National Comprehensive Cancer Network; October 1, 2026. Accessed October 1, 2026.