Oncologic outcome of parosteal osteosarcoma

Hoshi, Manabu; Matsumoto, Seiichi; Manabe, Jun; Tanizawa, Taisuke; Shigemitsu, Toshio; Izawa, Naohiro; Shi, Xuedong; Kawaguchi, Noriyoshi

doi:10.1007/s10147-005-0545-2

Cited by 16 publications

(12 citation statements)

References 10 publications

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“…The reason for this is that for better function less tissue needs to be removed which could result in a high risk of recurrence. We also found that the mean MSTS functional scores for the patients who had microwave-induced hyperthermia were better than scores reported in other limb salvage studies [13, 23, 24]. There could be several reasons for this, although all are somewhat speculative.…”

Section: Discussionmentioning

confidence: 40%

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Is Limb Salvage With Microwave-induced Hyperthermia Better Than Amputation for Osteosarcoma of the Distal Tibia?

Han

Dang

Bian

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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BackgroundAmputation has been the standard surgical treatment for distal tibia osteosarcoma owing to its unique anatomic features. Preliminary research suggested that microwave-induced hyperthermia may have a role in treating osteosarcoma in some locations of the body (such as the pelvis), but to our knowledge, no comparative study has evaluated its efficacy in a difficult-to-treat location like the distal tibia.QuestionsDoes microwave-induced hyperthermia result in (1) improved survival, (2) decreased local recurrence, (3) improved Musculoskeletal Tumor Society (MSTS) scores, or (4) fewer complications than amputation in patients with a distal tibial osteosarcoma?MethodsBetween 2000 and 2015, we treated 79 patients for a distal tibia osteosarcoma without metastases. Of those, 52 were treated with microwave-induced hyperthermia, and 27 with amputation. Patients were considered eligible for microwave-induced hyperthermia if they had an at least 20-mm available distance from the tumor edge to the articular surface, good clinical and imaging response to neoadjuvant chemotherapy, and no pathologic fracture. Patients not meeting these indications were treated with amputation. In addition, if neither the posterior tibial artery nor the dorsalis pedis artery was salvageable, the patients were treated with amputation and were not included in any group in this study. A total of 13 other patients were treated with conventional limb-salvage resections and reconstructions (at the request of the patient, based on patient preference) and were not included in this study. All 79 patients in this retrospective study were available for followup at a minimum of 12 months (mean followup in the hyperthermia group, 79 months, range 12–158 months; mean followup in the amputation group, 95 months, range, 15–142 months). With the numbers available, the groups were no different in terms of sex, age, tumor grade, tumor stage, or tumor size. All statistical tests were two-sided, and a probability less than 0.05 was considered statistically significant. Survival to death was evaluated using Kaplan-Meier analysis. Complications were recorded from the patients’ files and graded using the classification of surgical complications described by Dindo et al.ResultsIn the limb-salvage group, Kaplan Meier survival at 6 years was 80% (95% CI, 63%–90%), and this was not different with the numbers available from survivorship in the amputation group at 6 years (70%; 95% CI, 37%–90%; p = 0.301).With the numbers available, we found no difference in local recurrence (six versus 0; p = 0.066). However mean ± SD MSTS functional scores were higher in patients who had microwave-induced hyperthermia compared with those who had amputations (85% ± 6% versus 66% ± 5%; p = 0.008).With the numbers available, we found no difference in the proportion of patients experiencing complications between the two groups (six of 52 [12%] versus three of 27 [11%]; p = 0.954).ConclusionsWe were encouraged to find no early differences in survival, local recurrence, or serious compl...

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Section: Discussionmentioning

confidence: 40%

“…Transtibial amputation was performed as common practice [13]. The goals and requirements were resecting the bone 2 cm to 3 cm proximal to abnormal bone density, obtaining adequate length of the residual limb, and achieving good soft tissue coverage.…”

Section: Methodsmentioning

confidence: 99%

Is Limb Salvage With Microwave-induced Hyperthermia Better Than Amputation for Osteosarcoma of the Distal Tibia?

Han

Dang

Bian

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…Additionally, since long potential medullary involvement in POS is known 19 and, in this context, has been discussed as an important issue in the decision‐making between segmental or less extensive excision 3, 7, 8. However, the incidence of local recurrence could not be linked to medullary involvement, but rather turned out as being closely dependent from adequate surgical margins 3–5, 7, 8, 15, 20. Besides, the extent of intramedullary alterations is often circumscript and still allows less extensive resection such as hemicortical excision without compromising clear margins 7, 8.…”

Section: Discussionmentioning

confidence: 99%

“…Extensive tumor size and involvement of vessels or nerves, however, still may indicate ablative procedures. Especially, tumor effusion into the adjacent joint space makes limited excision hard or impossible to achieve and therefore mostly will require endoprosthetic reconstruction 15, 20. Throughout this retrospective study different forms of surgical treatment of POS have been applied and consequently our algorithm of indication today is based on tumor site and local extension, proximity to neurovascular structures, joint invasion, and extent of medullary involvement.…”

Section: Discussionmentioning

confidence: 99%

Treatment and outcome of parosteal osteosarcoma: Biological versus endoprosthetic reconstruction

Funovics

Bucher

Toma

et al. 2011

Journal of Surgical Oncology

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“…Dedifferentiation induces tumor spread and is associated with a poor prognosis. No adjuvant therapy is necessary in low-grade lesions, but patients presenting with metastases or a high-grade POS should undergo adjuvant chemotherapy[3],[6],[10],[11],[17]–[22]. Temple et al [5].…”

Section: Discussionmentioning

confidence: 99%

Local recurrence of a parosteal osteosarcoma 21 years after incomplete resection

Combalía¹,

Muñoz-Mahamud²,

Palacin³

et al. 2011

Chin J Cancer

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Parosteal osteosarcoma (POS) is the most common form of surface osteosarcoma. Its symptoms are insidious and its duration prior to diagnosis is considerably longer than that of other types of osteosarcoma. We report a case of POS with a growing mass but no evidence of metastasis. This tumor, which was diagnosed as calcified hematoma with benign characteristics, was incompletely resected in our hospital 21 years before the diagnosis of recurrence. The patient underwent a wide en bloc resection in our hospital and was free of symptoms, with no signs of tumor recurrence or metastasis during a 53-month follow-up.

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Oncologic outcome of parosteal osteosarcoma

Cited by 16 publications

References 10 publications

Is Limb Salvage With Microwave-induced Hyperthermia Better Than Amputation for Osteosarcoma of the Distal Tibia?

Is Limb Salvage With Microwave-induced Hyperthermia Better Than Amputation for Osteosarcoma of the Distal Tibia?

Treatment and outcome of parosteal osteosarcoma: Biological versus endoprosthetic reconstruction

Local recurrence of a parosteal osteosarcoma 21 years after incomplete resection

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