scholarly journals Implant Associated Local Recurrence in Primary Bone Sarcoma

2020 ◽  
Vol 71 (1) ◽  
pp. 172-175 ◽  
Author(s):  
Zsombor Panti ◽  
Bogdan Cretu ◽  
Corina Panaitescu ◽  
Mihai Nica ◽  
Camelia Tecu ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Local Recurrence ◽  
Environmental Changes ◽  
Tumor Resection ◽  
Distant Metastases ◽  
Bone Sarcoma ◽  
Wide Resection ◽  
Sarcoma Cell ◽  
The Past ◽  
Primary Bone Sarcoma

Hydroxyapatite (HA) covered implants are widely used in orthopedic reconstructive surgery. Their biological benefits were highlighted by several studies in the past decades in which the most important ones are the osteoconductive and osteoinductive capacity, which enhances osteoblast adherence, proliferation and bone extracellular matrix formation. In bone sarcomas the micro-environmental changes are crucial for tumor growth, new bone formation especially in osteoblastic osteosarcomas (OS). Nowadays limb sparing surgery and maintaining the quality of patient�s life are the main two goals in bone sarcoma treatment. The survival rate of patients with OS has been significantly improved in the past 3-4 decades due to the advanced chemotherapy protocols. The prognosis still depends on the early diagnosis and the histological type of the sarcoma. Tumor removal and reconstruction is a crucial moment for prognosis, studies showed that high grade sarcomas have a greater potential for local recurrence and early distant metastases. Metastasis can occur in early stages, even if there are not detectable at the time of surgery. Furthermore, the micro-environmental changes can facilitate sarcoma cell proliferation even if the tumor resection was performed in macroscopically normal bone tissue. We present a case of osteosarcoma in which local recurrence has occurred despite of chemotherapy and wide resection of the tumor. We can ask the following question can an implant increases the risk of local recurrence in sarcoma surgerys The aim of the study was to understand the underlying molecular pathway for sarcoma cell proliferation in HA covered implants.

scholarly journals Sarcomas of the extremities and the pelvis: comparing local recurrence after incisional and after core-needle biopsy

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexander Klein ◽  
Christof Birkenmaier ◽  
Julian Fromm ◽  
Thomas Knösel ◽  
Dorit Di Gioia ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Tumor Resection ◽  
Soft Tissue Sarcomas ◽  
Wide Resection ◽  
Incisional Biopsy ◽  
Core Needle

Abstract Background The degree of contamination of healthy tissue with tumor cells during a biopsy in bone or soft tissue sarcomas is clearly dependant on the type of biopsy. Some studies have confirmed a clinically relevant contamination of the biopsy tract after incisional biopsies, as opposed to core-needle biopsies. The aim of our prospective study was to evaluate the risk of local recurrence depending on the biopsy type in extremity and pelvis sarcomas. Methods We included 162 patients with a minimum follow-up of 6 months after wide resection of extremity sarcomas. All diagnostic and therapeutic procedures were performed at a single, dedicated sarcoma center. The excision of the biopsy tract after an incisional biopsy was performed as a standard with all tumor resections. All patients received their follow-up after the conclusion of therapy at our center by means of regional MRI studies and, at a minimum, CT of the thorax to rule out pulmonary metastatic disease. The aim of the study was the evaluation of the influence of the biopsy type and of several other clinical factors on the rate of local recurrence and on the time of local recurrence-free survival. Results One hundred sixty-two patients with bone or soft tissue tumors of the extremities and the pelvis underwent either an incisional or a core-needle biopsy of their tumor, with 70 sarcomas (43.2%) being located in the bone. 84.6% of all biopsies were performed as core-needle biopsies. The median follow-up time was 55.6 months, and 22 patients (13.6%) developed a local recurrence after a median time of 22.4 months. There were no significant differences between incisional and core-needle biopsy regarding the risk of local recurrence in our subgroup analysis with differentiation by kind of tissue, grading of the sarcoma, and perioperative multimodal therapy. Conclusions In a large and homogenous cohort of extremity and pelvic sarcomas, we did not find significant differences between the groups of incisional and core-needle biopsy regarding the risk of local recurrence. The excision of the biopsy tract after incisional biopsy in the context of the definitive tumor resection seems to be the decisive factor for this result.

scholarly journals Pediatric Chondrosarcoma of the Sternum Resected with Thorascopic Assistance

2017 ◽  
Vol 11 (1) ◽  
pp. 479-485 ◽  
Author(s):  
Harpreet S. Bawa ◽  
Drew D. Moore ◽  
Juan C. Pelayo ◽  
Nicole Cipriani ◽  
Grace Mak ◽  
...  
Keyword(s):  
Chest Wall ◽  
Soft Tissues ◽  
Thoracoscopic Surgery ◽  
Bone Sarcoma ◽  
Wide Resection ◽  
Malignant Neoplasms ◽  
Low Grade ◽  
Orthopaedic Oncology ◽  
Primary Bone Sarcoma ◽  
Primary Bone

Background: Chondrosarcomas are a heterogeneous group of malignant neoplasms that arise from bones, cartilage or other soft tissues that produce cartilage and are commonly seen in the middle decades of life. Despite being the most common primary bone sarcoma in adults, chondrosacromas are rare in pediatric patients. Case Report: We report the case of a six-year-old child with a painless enlarging sternal mass of which biopsy was consistent with low-grade surface chondrosarcoma. This is the first reported case of a chest wall chondrosarcoma in a young child. This unusual location in a young patient presented challenges to treatment. Resection of the manubrium was performed by a multidisciplinary team of orthopaedic oncology and pediatric general surgery. The patient underwent a wide resection of the sternal mass from an anterior approach performed by the orthopaedic oncology team using an oscillating saw under video-assisted thoracoscopic surgery to ensure adequate mass resection without injury to nearby structures. The patient was followed with quarterly physical exams and radiographs for 18 months postoperatively and did not have any pain or evidence of recurrence. Conclusion: Clinicians should consider utilizing multidisciplinary approaches to treat patients with chondrosarcomas of the chest wall.

scholarly journals Low grade fibromyxoid sarcoma (Evans tumour) of the arm

2014 ◽  
Vol 47 (02) ◽  
pp. 259-262 ◽  
Author(s):  
Shalaka Indap ◽  
Manjiri Dasgupta ◽  
Nilay Chakrabarti ◽  
Abhishek Agarwal
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Distant Metastasis ◽  
Wide Resection ◽  
Soft Tissue Tumour ◽  
Low Grade ◽  
Deep Soft Tissue ◽  
The Past ◽  
Tissue Tumour ◽  
Fibromyxoid Sarcoma

ABSTRACTA low-grade fibromyxoid sarcoma is a rare soft tissue tumour that has a tendency to develop in the deep soft tissue of young adults with potential for local recurrence or distant metastasis. We describe a 40-year-old female patient with a low-grade fibromyxoid sarcoma of the shoulder that had been excised twice in the past and then had recurred after a few months. A wide resection of this tumour with flap reconstruction was performed followed by radiation to the area. The patient had no evidence of local recurrence or distant metastasis at 2 years after surgery.

Primary Index Finger Pollicization for Thumb Reconstruction Following Soft Tissue Sarcoma Excision

Hand Surgery ◽  
2015 ◽  
Vol 20 (03) ◽  
pp. 453-457 ◽  
Author(s):  
Velagala Satyanarayana Reddy ◽  
Adam Sierakowski ◽  
Madhu Periasamy ◽  
Shanmuganathan Raja Sabapathy
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Index Finger ◽  
Hand Function ◽  
Soft Tissue Sarcomas ◽  
Distant Metastases ◽  
Wide Resection ◽  
Thumb Reconstruction ◽  
Recurrence Rates ◽  
Interosseous Artery

Soft tissue sarcomas in the thumb are rare, but often require amputation to ensure tumour clearance. This can severely impair the use of the entire upper limb and negatively impact quality of life. We describe a 63-year-old male patient with a large malignant fibrous histiocytoma affecting the base of his dominant right thumb. A wide resection of this tumour was performed, followed immediately by index finger pollicization and first web space reconstruction with a reverse pedicled posterior interosseous artery flap. The patient was able to continue using his right hand for functions of daily living and was free from local recurrence until he died from distant metastases 2 years later. Primary thumb reconstruction following amputation for sarcoma can allow a patient to retain useful hand function postoperatively. Provided that strict principles of tumour clearance are adhered to, this need not compromise local recurrence rates.

scholarly journals Why Rotationplasty? A Qualitative Study of Decision-Making by Families of Patients With Primary Bone Sarcoma

2022 ◽  
Vol 9 ◽  
pp. 237437352110698
Author(s):  
Chung M Chan ◽  
Adam D. Lindsay ◽  
Andre R V Spiguel ◽  
C. Parker Gibbs ◽  
Mark T Scarborough
Keyword(s):  
Decision Making ◽  
Tumor Resection ◽  
Bone Sarcoma ◽  
Surgical Reconstruction ◽  
Decision Making Process ◽  
Structured Interviews ◽  
Primary Bone Tumors ◽  
Primary Bone Sarcoma ◽  
Primary Bone ◽  
Established Technique

Rotationplasty is an established technique that is indicated as part of the surgical reconstruction for certain patients with primary bone tumors around the knee who undergo tumor resection. There is considerable variation in the application of rotationplasty by surgeons as well as acceptance of the procedure by patients who may be candidates for this procedure. We qualitatively studied the decision-making process of families of patients who had undergone rotationplasty by interviewing 4 patients and their families using semi-structured interviews. Thematic analysis identified the following themes that were important in the decision-making process: (1) the desire for good information sources, (2) finding value in meeting with other patients who had been faced with a similar decision, (3) prioritizing function over cosmesis, (4) a desire to limit the need for revision surgeries, and (5) accepting that a return to normalcy is not an option with a surgery. Physicians and patients faced with a similar decision can benefit from a better understanding of the process, and by the normalization of anxieties and concerns that they may experience.

scholarly journals Climate and environmental changes during the past millennium in central western Guizhou, China as recorded by Stalagmite ZJD-21

2011 ◽  
Vol 40 (6) ◽  
pp. 1111-1120 ◽  
Author(s):  
Tz-Shing Kuo ◽  
Zi-Qi Liu ◽  
Hong-Chun Li ◽  
Nai-Jung Wan ◽  
Chuan-Chou Shen ◽  
...  
Keyword(s):  
Environmental Changes ◽  
The Past ◽  
Western Guizhou ◽  
Past Millennium

scholarly journals ETMR-15. USE OF HIGH-DOSE CHEMOTHERAPY FOR TWO CHILDREN WITH EMBRYONAL TUMOR WITH MULTILAYERED ROSETTES

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii326-iii326
Author(s):  
Shimpei Kusano ◽  
Junya Fujimura ◽  
Megumi Fujiwara ◽  
Akinori Yaguchi ◽  
Takeshi Ishibashi ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Tumor Resection ◽  
Radical Resection ◽  
Multicenter Trial ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Embryonal Tumor ◽  
The Central Nervous System ◽  
Classification Of Tumors ◽  
Multiagent Chemotherapy

Abstract Embryonal tumor with multilayered rosettes (ETMR) is new entity defined in the 4th revised edition of the WHO classification of tumors of the central nervous system. Although radical resection, radiotherapy, and multiagent chemotherapy are considered to be necessary for ETMR, the efficacy of chemotherapy for ETMR in Japan has not been established. Here, we report different clinical courses for two children with localized ETMR treated with the St. Jude medulloblastoma-96 (SJMB96) regimen, which consists of four cycles of high-dose chemotherapy with autologous peripheral blood stem cell transplantation. For both children, the diagnosis of ETMR, C19MC-altered was confirmed after gross total tumor resection. Multiagent chemotherapy was administered following cranio-spinal irradiation with local boost. One month after completion of the treatment, one patient experienced local recurrence but has been in remission for over 2 years after tumor resection and stereotactic irradiation with a CyberKnife and treatment every three weeks with bevacizumab. The other patient also experienced local recurrence after the third cycle of chemotherapy and several times thereafter. Although she again underwent tumor resection and local irradiation, her tumor grew larger and invaded. Because her prognosis was very poor, her parents choose only palliative care. Based on our experience, we believe that continuous chemotherapy at conventional doses is preferred over intensive-dose chemotherapy such as SJMB96. However, the number of reports on chemotherapy for ETMR is still small, and a prospective multicenter trial is needed to establish effective chemotherapy for ETMR.

scholarly journals Loco-regional recurrence trend and prognosis in young women with breast cancer according to molecular subtypes: analysis of 1099 cases

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yang Li ◽  
Su Lu ◽  
Yuhan Zhang ◽  
Shuaibing Wang ◽  
Hong Liu
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Molecular Subtypes ◽  
Early Stage ◽  
Young Patients ◽  
Distant Metastases ◽  
Early Stage Breast Cancer ◽  
Regional Recurrence ◽  
Her2 Status ◽  
Over Time

Abstract Background The number of young patients diagnosed with breast cancer is on the rise. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes. Methods A retrospective cohort study was conducted based on data from Tianjin Medical University Cancer Institute and Hospital for patients ≤ 35 years of age with pathologically confirmed primary invasive breast cancer surgically treated between 2006 and 2014. Patients were categorized according to molecular subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year rates for LR, RR, and distant metastases (DM) were estimated by Kaplan-Meir statistics. Nelson-Aalen cumulative-hazard plots were used to describe local recurrence- and distant metastasis-free intervals. Results We identified 25,284 patients with a median follow-up of 82 months, of whom 1099 (4.3%) were YBC patients ≤ 35 years of age. The overall 5-year LR, RR, and DM rates in YBC patients were 6.7%, 5.1%, and 16.6%, respectively. The LR and RR rates demonstrated a decreasing trend over time (P = 0.028 and P = 0.015, respectively). We found that early-stage breast cancer and less lymph node metastases increased over time (P = 0.004 and P = 0.007, respectively). Patients with HR−/HER2+ status had a significantly higher LR (HR 20.4; 95% CI, 11.8–35.4) and DM (HR 37.2; 95% CI, 24.6–56.3) at 10 years. Breast-conserving surgery (BCS) or mastectomy did not influence rates of LR and RR. In the overall population, the 5-year survival of YBC patients exceeded 90%. Conclusions The rates of LR and RR with YBC patients demonstrated a downward trend and the proportion of early-stage breast cancer increased between 2006 and 2014. We report the highest LR rates in this young population were associated with HR−/HER2+ tumors.

scholarly journals Transanal total mesorectal excision: short- and long-term results of the first hundred cases of a certified colorectal cancer center in Germany

2021 ◽  
Author(s):  
Vinzenz Völkel ◽  
Sabine Schatz ◽  
Teresa Draeger ◽  
Michael Gerken ◽  
Monika Klinkhammer-Schalke ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Tumor Resection ◽  
Operation Time ◽  
Cancer Center ◽  
Transanal Total Mesorectal Excision ◽  
Local Tumor ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Short And Long Term

Abstract Background Since 2010, laparoscopic transanal total mesorectal excision (TaTME) has been increasingly used for low and very low rectal cancer. It is supposed to improve visibility and access to the dissection planes in the pelvis. This study reports on short- and long-term outcomes of the first 100 consecutive patients treated with TaTME in a certified German colorectal cancer center. Patients and methods Data were derived from digital patient files and official cancer registry reports for patients with TaTME tumor surgery between July 2014 and January 2020. The primary outcome was the 3-year local recurrence rate and local recurrence-free survival (LRFS). Secondary endpoints included overall survival (OAS), disease-free survival (DFS), operation time, completeness of local tumor resection, lymph node resection, and postoperative complications. The Kaplan–Meier method was employed for the survival analyses; competing risks were considered in the time-to-event analysis. Results During the observation period, the average annual operation time decreased from 272 to 178 min. Complete local tumor resection was achieved in 97% of the procedures. Major postoperative complications (Clavien–Dindo 3–4) occurred in 11% of the cases. At a median follow-up time of 2.7 years, three patients had suffered from a local recurrence. Considering competing risks, this corresponds to a 3-year cumulative incidence rate for local recurrence of 2.2% and a 3-year LRFS of 81.9%. 3-year OAS was 82.9%, and 3-year DFS was 75.7%. Conclusion TaTME is associated with favorable short and long-term outcomes. Since it is technically demanding, structured training programs and more research on the topic are indispensable.

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