Until the last four decades, the main treatment for primary malignant musculoskeletal system tumors located in the extremities was accepted as amputation, and the survival rate of the patients did not exceed 20% despite amputation. With a better understanding of sarcoma biology, the determination of surgical treatment principles, the advancement of surgical techniques, the emergence of multi-drug chemotherapy protocols and advanced radiotherapy applications, and the establishment of specialized centers with experienced multidisciplinary teams, the philosophy of limb sparing/salvage surgery was born. Although we are far ahead in the journey of orthopedic oncology compared to where we started, and we can bring many patients back to life with their functional limbs, today there is still a group of patients (approximately 35%), who die even though they are treated at the right time and at the right address. Our expectation from the future of orthopedic oncology is to provide an organization, where all patients can be treated under ideal conditions, and to provide a cure for patients that we have not been able to save, no matter what we have done so far, in the light of scientific and technological developments.