Neoadjuvante Therapie des lokalisierten Osteosarkoms der Extremitäten

Bielack, Stefan; Kempf-Bielack, B.; Schwenzer, D.; Birkfellner, T.; Delling, G.; Ewerbeck, V.; Exner, G. U.; Fuchs, N.; Göbel, U.; Graf, N.; Heise, U.; Helmke, K.; Hochstetter, A.R.; Jürgens, H.; Maas, R.; Münchow, N.; Salzer-Kuntschik, M.; Treuner, J.; Veltmann, U.; Werner, Mathias; Winkelmann, Winfried; Zoubek, A.; Kotz, R.

doi:10.1055/s-2007-1019701

Cited by 32 publications

(8 citation statements)

References 29 publications

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“…Neoadjuvant chemotherapy, according to the Cooperative Osteosarcoma Study Group (COSS) 96 study protocol was given. 1 A thorough staging revealed no metastasis. A wide below-knee amputation, according to the Enneking classification system, 6 was done in April, 2000, followed by adjuvant chemotherapy according to the COSS 96 study protocol.…”

Section: Case Reportmentioning

confidence: 96%

“…A wide below-knee amputation, according to the Enneking classification system, 6 was done in April, 2000, followed by adjuvant chemotherapy according to the COSS 96 study protocol. 1 The amputation specimen contained more than 50% vital tumor cells, corresponding to a histological regression grade 5 osteosarcoma, according to the Salzer-Kuntschik scale. 18 A revision of the stump was required one time, but as of July, 2003, the patient was alive with no evidence of disease at 39 months followup.…”

Section: Case Reportmentioning

confidence: 99%

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Two Cases of Calcaneal Osteosarcomas Presenting as Aneurysmal Bone Cysts

et al. 2004

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Section: Case Reportmentioning

confidence: 96%

Section: Case Reportmentioning

confidence: 99%

Two Cases of Calcaneal Osteosarcomas Presenting as Aneurysmal Bone Cysts

et al. 2004

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“…Six patients were treated according to the Cooperative Osteosarcoma Study (COSS 86) [22], 17 patients received the modified treatment of the Cooperative Osteosarcoma Study (COSS 96) [3], and two each were treated according to the principles of the European and American Osteosarcoma Study (EURAMOS) [21] and EUROpean Bone Over 40 Sarcoma Study (EURO-BOSS) [4].…”

Section: Patientsmentioning

confidence: 99%

What Sports Activity Levels Are Achieved in Patients With Modular Tumor Endoprostheses of Osteosarcoma About the Knee?

Lang

Hobusch

Funovics

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Advances in multimodal treatment have improved survival of patients with nonmetastatic osteosarcoma. At the same time, implant design has improved the outcomes of limb salvage with modular endoprostheses. However, little is known about sports activity in longterm survivors with osteosarcoma. Questions/purposes We wanted to evaluate (1) sports activity levels in long-term survivors of osteosarcoma about the knee who received a modular tumor endoprosthesis; (2) to determine if activity level changed over time from initial reconstruction or (3) was predicted from sports activity level before diagnosis; and (4) if complications that occurred affected sports or contributed to prosthetic failures. Methods Between 1995 and 2005, we treated 120 patients for osteosarcoma about the knee with resection and modular endoprosthetic reconstruction; of those, 25 (21%) have died, six (5%) had an amputation, 39 (32%) did not speak German and so were ineligible, and 14 (12%) were either lost to followup or refused to participate, leaving 27 patients (14 females, 13 males; median age 19 years [range, 12-60 years); average followup 11 ± 4 years) (54% of the living, German-speaking cohort) for this analysis. Tumors were located in the distal femur (n = 16) and the proximal tibia (n = 11). Sports participation as well as the UCLA Activity Score and the modified Weighted Activity Score were assessed retrospectively. Moreover, postoperative complications were evaluated. Results Before the diagnosis of osteosarcoma and 1, 3, and 5 years and at the latest followup, respectively, after their reconstructions, 24 (89%), nine (33%), 20 (74%), and 24 patients (89%) were able to perform sports activities. There was a reduction in high-impact activities. Those patients with followup longer than 5 years had no changes in sports activity at their latest followup. Patients who had higher levels of sports activity levels before surgery generally had higher levels of activity at last followup (UCLA Activity Score: r = 0.62, p \ 0.0005; modified Weighted Activity Score r = 0.49, p \ 0.01). Fourteen patients (51%) underwent revision surgery. With the numbers available, complications had no effect on sports activity. No sports activity-related complications were found. Conclusions Some long-term survivors of osteosarcoma can achieve high levels of sports activity. Preoperative activity levels seem to influence the postoperative activity levels. This information is important to give realistic expectations for long-term survivors of osteosarcoma of the knee.

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“…Both tumors affect the long bones of the appendicular skeleton and occur with occult metastases at the time of diagnosis in as much as 90% of cases [3]. Chemotherapy, following standardized study protocols [3,4,6,7,15,21,31], and potential radiotherapy (Ewing's sarcoma) in addition to wide resection have been seen to increase patients' survival [19]. Although the 5-year survival rate for patients with nonmetastasized Ewing's sarcoma has been less than 10% with resection only (with or without radiotherapy) [3], it has reached 50% to 75% with additional chemotherapeutic treatment [3].…”

Section: Introductionmentioning

confidence: 99%

Osteoporosis in Children and Young Adults: A Late Effect After Chemotherapy for Bone Sarcoma

Pirker-Frühauf

Friesenbichler

Urban

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Premature bone loss after childhood chemotherapy may be underestimated in patients with bone sarcoma. Methotrexate (MTX), a standard agent in osteosarcoma protocols, reportedly reduces bone mineral density (BMD). The literature, however, has reported cases of BMD reduction in patients with Ewing's sarcoma treated without MTX. Thus, it is unclear whether osteoporosis after chemotherapy relates to MTX or to other factors. Questions/purposes We therefore asked whether (1) young patients with a bone sarcoma had BMD reduction, (2) patients treated with MTX had lower BMD, and (3) other factors (eg, lactose intolerance or vitamin D deficiency) posed additional risks for low BMD. Methods We retrospectively reviewed 43 patients with malignancies who had dual-energy x-ray absorptiometry (DEXA) (lumbar, femoral); 18 with Ewing's sarcoma (mean age, 26 ± 8 years), and 25 with an osteosarcoma (mean age, 27 ± 10 years). The mean time since diagnosis was 8 ± 4 years in the group with Ewing's sarcoma and 7 ± 5 years in the group with osteosarcoma. At last followup we determined BMD (computing z-scores), fracture rate, and lifestyle, and performed serum analysis. Results BMD reduction was present in 58% of patients (37% had a z-score between À1 and À2 SD, 21% had a z-score less than À2 SD) in at least one measured site. Seven of the 43 patients (16%) had nontrauma or tumor-associated fractures after chemotherapy. Findings were similar in the Ewing and osteosarcoma subgroups. We found vitamin D deficiency in 38 patients (88%) and borderline elevated bone metabolism; lactose intolerance was present in 16 patients (37%). Conclusion Doctors should be aware of the possibility of major bone loss after chemotherapy with a risk of pathologic fracture. Vitamin D deficiency, calcium malnutrition, and lactose intolerance may potentiate the negative effects of chemotherapy, and should be considered in long-term patient management. Level of Evidence Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Neoadjuvante Therapie des lokalisierten Osteosarkoms der Extremitäten

Cited by 32 publications

References 29 publications

Two Cases of Calcaneal Osteosarcomas Presenting as Aneurysmal Bone Cysts

Two Cases of Calcaneal Osteosarcomas Presenting as Aneurysmal Bone Cysts

What Sports Activity Levels Are Achieved in Patients With Modular Tumor Endoprostheses of Osteosarcoma About the Knee?

Osteoporosis in Children and Young Adults: A Late Effect After Chemotherapy for Bone Sarcoma

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