Intentional marginal excision of osteosarcoma of the proximal fibula to preserve limb function

Kanazawa, Yoshimitsu; Tsuchiya, Hiroyuki; Nonomura, Akitaka; Takazawa, Koutarou; Yamamoto, Norio; Tomita, Katsuro

doi:10.1007/s00776-003-0714-y

Cited by 27 publications

(24 citation statements)

References 14 publications

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“…Therefore, a wide excision is considered mandatory to achieve the complete removal of a tumor (1,19,20). However, a wide excision often necessitates removal of functional structures, resulting in prolonged surgery time and compromised limb function (3,8,(20)(21)(22). Furthermore, recurrences and metastases are not rare in patients undergoing a wide excision of a tumor (1,19).…”

Section: Discussionmentioning

confidence: 99%

Intentional marginal resection of periosteal osteosarcoma in combination with neoadjuvant chemotherapy: A report of two cases and a review of the literature

Chen

et al. 2017

Oncology Letters

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Abstract.A wide resection of the tumor with or without chemotherapy is the treatment of choice for periosteal osteosarcoma (PO) of the extremities, however, post-operative limb function and quality of life could be compromised. The present study reports two cases of 14-year-old boys who presented with progressively enlarging masses in their right knee regions. Computed tomography and magnetic resonance imaging scans indicated a fusiform space-occupying mass encircling the bone cortex, with stippled calcification. A diagnosis of PO was suspected. The histological findings confirmed the diagnosis of intermediate PO. Pre-operative chemotherapies were started, and good responses were detected by clinical evaluation and histological findings. Surgeries preserving the functional structures, including neurovascular bundles, tendons, muscles and epiphyses, were performed, followed by routine chemotherapy. The two patients experienced disease-free survival with follow-up times of 37 and 108 months, respectively. The patients were satisfied with the results of the treatment and they returned to normal life activities. These two cases indicated that a marginal resection of the tumor in conjunction with effective neoadjuvant chemotherapy may be an ideal alternative treatment for intermediate PO, since survival along with well-preserved limb function could be guaranteed. By contrast, a wide excision could result in the loss of limb function.

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Section: Discussionmentioning

confidence: 99%

Intentional marginal resection of periosteal osteosarcoma in combination with neoadjuvant chemotherapy: A report of two cases and a review of the literature

Chen

et al. 2017

Oncology Letters

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“…Inadequate surgical margins are responsible for poor outcomes because of the high rate of local recurrence and metastasis [33]. This view has been recently challenged by other authors, who observed no recurrence and no impact on survival in patients with fibular osteosarcomas who had undergone intentional marginal resection and adjuvant therapy [5,34]. It is likely that advances in chemotherapy will render limb-salvage surgery increasingly popular [3].…”

Section: Discussionmentioning

confidence: 99%

Clinical management and surgical treatment of distal fibular tumours: a case series and review of the literature

Perisano

Marzetti

Spinelli

et al. 2012

International Orthopaedics (SICOT)

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Purpose Study reports clinical and functional outcomes of surgical treatment in a case series of nine patients with distal fibular tumours. Methods Nine patients with distal fibular tumours were observed between 2005 and 2010. A PubMed search was performed using the terms "fibula", "lower limb tumour [cancer]", "sarcoma", "Ewing", "peroneal", "fibular metastasis", and "limb-salvage surgery". Results In all our patients, lesions were unilateral. All patients complained of pain; limping was present in 5 of 9 tumours. Patients were managed surgically, except one who underwent local radiotherapy. In six patients, a benign or tumor-like lesion was detected. Malignancies consisted of metastatic lung adenocarcinoma (two cases) or multifocal mesenchymal cancer (one case). Non-malignant lesions were treated by curettage and filling, followed by internal fixation when needed. In malignant or locally aggressive lesions, metadiaphyseal fibular resection was performed. The literature search retrieved either case reports or small case series, reflecting the rarity of distal fibular tumours. Surgical treatment was successful in all patients with benign lesions, whereas the rate of success was 40-100 % in case of malignancies. Conclusions Given the low incidence of distal fibular tumours, controversies exist about the optimal surgical management. Clinical observation and imaging should be reserved to asymptomatic benign lesions. In non-malignant tumours causing pain, limping, and pathological fractures; in malignancies, surgery is recommended. Finally, in patients with asymptomatic lesions of uncertain nature, biopsy and histological examination should be performed to plan appropriate management.

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“…19) They demonstrated in several studies that caffeine-potentiated chemotherapy induces a high complete response rate (86%) in patients with osteosarcoma. 18,20,21) In addition, they reported an overall 5-year cumulative survival rate of 80.7% for nonmetastatic soft tissue sarcoma patients with a median follow-up period of 52 months. 22) Because the serious side effects such as bonemarrow depression shown in treatment with other anticancer agents did not occur with caffeine, it seems that caffeineassisted chemotherapy is a safer and more effective form of chemotherapy.…”

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confidence: 99%

Caffeine Increases the Antitumor Effect of Cisplatin in Human Hepatocellular Carcinoma Cells

Kawano

Nagata

Kohno

et al. 2012

Biological & Pharmaceutical Bulletin

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Caffeine is thought to increase the antitumor effect of cisplatin or DNA-damaging agents because it is known that caffeine inhibits DNA repair. Caffeine-assisted chemotherapy has been used in the treatment of osteosarcomas. In addition, there are several reports about combination chemotherapy with caffeine for certain malignancies other than osteosarcomas. However, there are no reports that show the utility of combination chemotherapy with caffeine for hepatocellular carcinoma (HCC). We examined the combined effects of caffeine and cisplatin in human HCC cell lines, and screened for a more effective administration method of caffeine in vitro. Human HCC cell lines (HepG2, HLF, HuH-7, and Li-7) were exposed to caffeine (0-0.5 mM) and cisplatin (0-1.2 μg/mL) for 72 h, either alone or in combination. Cell numbers were measured by WST-8 assay, and cell apoptosis was determined by annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) binding assay. As a result, caffeine increased the antitumor effect of cisplatin on cell proliferation and cell apoptosis in the HCC cell lines. Moreover, this effect was dependent on the amount of exposure to caffeine. These results suggest that caffeine-assisted chemotherapy is useful for HCC treatment.

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Intentional marginal excision of osteosarcoma of the proximal fibula to preserve limb function

Cited by 27 publications

References 14 publications

Intentional marginal resection of periosteal osteosarcoma in combination with neoadjuvant chemotherapy: A report of two cases and a review of the literature

Intentional marginal resection of periosteal osteosarcoma in combination with neoadjuvant chemotherapy: A report of two cases and a review of the literature

Clinical management and surgical treatment of distal fibular tumours: a case series and review of the literature

Caffeine Increases the Antitumor Effect of Cisplatin in Human Hepatocellular Carcinoma Cells

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