Local and Systemic Control After Ablative and Limb Sparing Surgery in Patients With Osteosarcoma

Sluga, Maria; Windhager, Reinhard; Lang, Susanna; Heinzl, Harald; Bielack, Stefan; Kotz, R.

doi:10.1097/00003086-199901000-00015

Cited by 108 publications

(83 citation statements)

References 17 publications

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“…Ewing's sarcoma differs from osteosarcoma in some respects: the mean age of the patients is younger than those with osteosarcoma and seldom occurs beyond the age of 30 years, local control can be achieved with radiation as well as resection, and the drugs used to treat Ewing's sarcoma are different than those used to treat osteosarcoma [3,20,31]. In addition to adequate local control, the use of aggressive polychemotherapy has remarkably improved the survival of patients with Ewing's sarcoma [10,25,32,37] since adjuvant chemotherapy was first introduced in the 1980s and has led to a growing number of long-term survivors [8,20,23]. However, chemotherapy can result in long-term late effects on the cardiac, pulmonary, and metabolic systems as well as on skeletal muscle [16].…”

Section: Introductionmentioning

confidence: 99%

Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Hobusch

Lang

Schuh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Limb salvage surgery has evolved to become the standard method of treating sarcomas of the extremities with acceptable oncologic results. However, little information exists relative to the activity level or ability to participate in sports after tumor reconstructions. Questions/purposes The aims of the study were to answer the following questions: (1) Which sports activity levels and what types of sports can be expected in the long term after tumor reconstruction? (2) Which frequency durations are patients with Ewing's sarcoma able to perform in longterm followup after local control? (3) Do surgical complications affect sports activity level? Methods Thirty patients (13 females, 17 males; mean age, 18 ± 8 years; range, 2-36 years at diagnosis; mean followup 16 ± 6 years [minimum, 5 years]) were included. Tumors were located in the pelvis, femur, tibia, and fibula. Surgical procedures included surgical resections alone (n = 8), surgical resection with biological reconstruction (n = 9), or endoprosthetic reconstruction (n = 13). We assessed UCLA sports activity levels, kinds of sports as well as the frequency per week and the duration of each training unit at long term (minimum followup, 5 years). Results In long-term followup 83% patients (25 of 30) were performing athletic activity regularly. The hours/ week of sports depended on type of surgery and were highest after resections in the pelvis and femur (5.8) and were lowest after megaprosthetic reconstruction of the pelvis (1.0). Patients undergoing biologic reconstructions were able to perform high-impact sports. UCLA sports activity levels were high after joint-preserving vascularized fibula for tibia reconstruction (7.4) and after megaprosthetic reconstruction of the lower extremity (6.3-6.4) and were low after tumors located in the fibula (4.2). Complications during followup did not significantly influence sports activity in long-term survivors.

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Section: Introductionmentioning

confidence: 99%

Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Hobusch

Lang

Schuh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Other similar series report 5 year survivor ship ranging from 28 % to 76 %. [9] It must be borne in mind there were relatively larger percentage of high grade tumors in our series and also that it includes chondrosarcoma which do have a viable and effective chemotherapy regimen. Currently, 80 % to 85 % of patients with primary malignant bone tumors involving the extremities (osteosarcoma, Ewing's sarcoma, and chondrosarcoma) can be treated safely with wide resection and limb preservation with or without reconstruction.…”

Section: Discussionmentioning

confidence: 85%

“…Currently, 80 % to 85 % of patients with primary malignant bone tumors involving the extremities (osteosarcoma, Ewing's sarcoma, and chondrosarcoma) can be treated safely with wide resection and limb preservation with or without reconstruction. [9] Simon et al [10] published the first evidence-based study supporting the benefits of limb-salvage procedures for the treatment of bone tumors. Their multicenter study, which included 227 patients with osteosarcoma of the distal end of the femur, reported the rates of local recurrence, metastasis, and survival.…”

Section: Discussionmentioning

confidence: 99%

“…The median resection length was 15 cm (range 6-25): the longest resections were performed in distal femur (median 16 cm, range 12-25), followed be proximal femur (median 15 cm, range 6-25) proximal tibia (median 12 cm, range [7][8][9][10][11][12][13][14][15] . No extra reconstructive interventions were needed for soft tissue coverage in any patients.…”

Section: Surgical Resectionmentioning

confidence: 99%

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Limb Salvage Surgery in Bone Tumors: A Retrospective Study of 50 Cases in a Single Center

Chauhan

Joshi

Chopra³

et al. 2013

Indian J Surg Oncol

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Modular segmental replacement system (MSRS) is one of the options for Limb conservation surgery in bone tumors. The study analyses a single center experience of use of MSRS for limb conservation in cases of primary bone tumors. Retrospective analysis was done for a series of cases of limb salvage procedures done over a five year period. All Patients with bone tumors who underwent limb salvage procedures utilising MSRS prosthesis were included in the study. The patients' record were perused for pre operative staging; neoadjuvant therapy used, if any; surgical procedure done; follow-up for prosthesis related complications and overall survival achieved. Total of 50 cases studied,included 28 males and 22 females . Median age at diagnosis of 28 (10-73) years. Tumor localized in lower limb in 38 patients, and upper limb in 12 patients. Tumors were malignant in 28 patients (56 %) and benign in 22 (44 %). The most common diagnosis was osteosarcoma (21 patients (42 %)) . The median resection length was 15 cm (range 6-25). High grade tumors (grade 2a and 2b) was found in 27 of 29 cases(93.1 %) . 14 patients had prosthesis related complications. The mean follow-up was 5 years (range: 3-7). 42 patients of 50 were alive with the endoprosthesis at the last follow-up. Survival rate of prosthesis is 84 %. The modular segmental-replacement system prosthesis favoured by us in limb sparing surgery for bone tumors results in satisfactory results in terms of tumor control and limb function.

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“…Localized tumors limited to the bone of origin have the best prognosis; 5-year survival varies between 60-75% (4,89,90,98,124,134). Patients with metastatic disease (20% at presentation) are typically treated by surgical resection of the primary tumor.…”

Section: Introduction Osteosarcomamentioning

confidence: 99%

Evolving gene therapy approaches for osteosarcoma using viral vectors: Review

Witlox

Lamfers

Wuisman

et al. 2007

Bone

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Local and Systemic Control After Ablative and Limb Sparing Surgery in Patients With Osteosarcoma

Cited by 108 publications

References 17 publications

Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Limb Salvage Surgery in Bone Tumors: A Retrospective Study of 50 Cases in a Single Center

Evolving gene therapy approaches for osteosarcoma using viral vectors: Review

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