Whether or not surgery is performed depends largely on the stage and location of the tumor as well as the hospital's protocol.  Generally, neoadjuvant therapy, such as chemotherapy or radiation, is performed prior to surgery. Chemotherapy and/or radiation can be very effective in shrinking the tumor, making it more easily operable.  The main difference is that chemotherapy treats the entire body, while radiation treats only the area where the tumor is located.  A child will typically undergo neoadjuvant therapy for 12 weeks, but this timeframe may vary based on the patient's diagnosis with different hospital protocols. 

If surgery is necessary, the family usually chooses which procedure will be performed - amputation, rotationplasty, or an endoprostheses.  Most physicians have their preferences and will give their recommendations. Depending on the hospital, the child's caregivers may also offer the family access to support groups.