Limb Salvage and Reconstruction Options in Osteosarcoma

Grinberg, Samuel; Posta, Abigail; Weber, Kristy; Wilson, Robert J.

doi:10.1007/978-3-030-43032-0_2

Cited by 31 publications

(31 citation statements)

References 43 publications

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“…The median age of osteosarcoma patients is 16 years, which appears to be associated with growth spurts [3] , [4] . At present, despite advancements in chemotherapy and surgery, the 5-year survival rates for primary and metastatic osteosarcoma remain<65% and 25%, respectively, with few treatment options [5] , [6] . Thus, it is essential to explore practical and safe therapeutic agents for osteosarcoma.…”

Section: Introductionmentioning

confidence: 99%

Baicalin induces apoptosis and autophagy in human osteosarcoma cells by increasing ROS to inhibit PI3K/Akt/mTOR, ERK1/2 and β-catenin signaling pathways

Pang

Peng

et al. 2022

Journal of Bone Oncology

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Section: Introductionmentioning

confidence: 99%

Baicalin induces apoptosis and autophagy in human osteosarcoma cells by increasing ROS to inhibit PI3K/Akt/mTOR, ERK1/2 and β-catenin signaling pathways

Pang

Peng

et al. 2022

Journal of Bone Oncology

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“…Once chemotherapy is over, however, the infection rate drops and the prosthesis is more endangered by mechanical wear and failure. 39,40 Hearing Loss…”

Section: Disabling Late Toxicities Mobilitymentioning

confidence: 99%

Current Insights into the Management of Late Chemotherapy Toxicities in Pediatric Osteosarcoma Patients

Hecker‐Nolting¹,

Langer²,

Blattmann³

et al. 2021

CMAR

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With ever increasing long-term, disease free survival rates, long-term toxicities of otherwise successful therapy have gained increasing importance. They can be grouped into potentially life-threatening, especially secondary malignancies and anthracycline cardiomyopathies, potentially disabling, particularly severe hearing loss and renal insufficiency, other, and rare events. Pathophysiology, frequency, and medical treatment approaches are discussed. Finally, fertility issues and quality of life issues are discussed, together with an outlook into the future. The challenge to cure as many patients as possible from osteosarcoma while enabling a life free of late effects will remain.

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“…With the advancement of diagnostic imaging and chemotherapy strategies, the 5-year survival rate for children has increased to 60–79% [ 3 , 4 ]. Due to the extended life expectancy and improvement in surgical techniques, limb salvage has replaced amputation as the gold standard and is now performed for 90–95% of upper extremity malignancies [ 2 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Free Vascularized Fibula Salvage of Failed CPH in Pediatric Sarcoma Patients

Pires

Moss

Luo

et al. 2022

Sarcoma

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Background. Due to extended life expectancy and recent improvements in surgical techniques, limb salvage has replaced amputation as the gold standard and is now performed in 90–95% of upper extremity malignancies. However, many of these salvage procedures are associated with significant postsurgical complications. In particular, the clavicula pro humero (CPH) procedure is associated with high rates of nonunion. We present our experience with upper extremity salvage using the free vascularized fibular flap (VFF) after failure or nonunion of the original CPH procedure in the pediatric population. Methods. Five patients under the age of 18 diagnosed with upper extremity sarcoma who underwent tumor resection with immediate CPH reconstruction complicated with nonunion, and subsequent revision with free VFF were included. Data on patient demographics, oncologic characteristics, surgical procedures, intraoperative details, postoperative complications, and time to graft union were recorded. Results. Five patients (average age = 8.4 years; range = 5–10 years at surgery date) underwent secondary limb salvage procedure with free VFF reconstruction following failed CPH reconstruction for proximal humeral osteosarcoma (n = 4) or Ewing sarcoma (n = 1). The mean follow-up was 3.7 years. Complications occurred in five patients (100%), with three patients requiring reoperation (60%). Four patients achieved graft union (average union time = 3.7 months) and successful limb reconstruction. Four patients were alive with no local recurrence of the disease. One patient did not achieve union and was lost to follow-up. Conclusion. Primary bone tumors in the pediatric population require wide surgical resection, and reconstruction often has high complication rates that can warrant further procedures. A free VFF is a viable option for upper extremity salvage after previously failed reconstructions because it provides vascularized tissue to a scarred tissue bed and allows for the replacement or augmentation of large bony defects.

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Limb Salvage and Reconstruction Options in Osteosarcoma

Cited by 31 publications

References 43 publications

Baicalin induces apoptosis and autophagy in human osteosarcoma cells by increasing ROS to inhibit PI3K/Akt/mTOR, ERK1/2 and β-catenin signaling pathways

Baicalin induces apoptosis and autophagy in human osteosarcoma cells by increasing ROS to inhibit PI3K/Akt/mTOR, ERK1/2 and β-catenin signaling pathways

Current Insights into the Management of Late Chemotherapy Toxicities in Pediatric Osteosarcoma Patients

Free Vascularized Fibula Salvage of Failed CPH in Pediatric Sarcoma Patients

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