Radiological characteristics and predisposing factors of venous tumor thrombus in pelvic osteosarcoma: A mono‐institutional retrospective study of 115 cases

Liang, Hui; W, Guo; Yang, Ru; Tang, Xiaodong; Yan, Taiqiang; Ji, Tao; Yang, Yi; Li, Dasen; Xie, Lu; Xu, Jie

doi:10.1002/cam4.1739

Cited by 5 publications

(9 citation statements)

References 33 publications

(107 reference statements)

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“…In the above study, although the multi-factor regression analysis showed that age and Pfirrmann's classification of intervertebral disc were independent factors, it also had certain influence on the curative effect, among them, the age increased, the water content of nucleus pulposus, the elasticity of intervertebral disc and the anti-load ability decreased gradually, at the same time, the elderly patients had poor physical fitness and their organ function and osteoporosis were poor, which brought some difficulties to the surgery, while the Pfirrmann's classification of disc degeneration reflects the degree of disc degeneration, the greater the grade, the greater the degree of disc degeneration and the worse the effect of LDH. This is similar to the results of the study by Haijie et al [15] .…”

Section: Resultssupporting

confidence: 93%

Analysis of Influencing Factors on Short-Term Efficacy of Percutaneous Transforaminal Endoscopic Lumbar Discectomy in the Treatment of Lumbar Disc Herniation

Duan¹,

Zhang²,

Ren³

et al. 2021

ijps

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To explore the factors influencing the short-term efficacy of percutaneous transforaminal endoscopic lumbar discectomy in the treatment of lumbar disc herniation is the main objective. 100 patients with lumbar disc herniation who were treated in our hospital from February 2017 to February 2019 were selected as the control group (n=85, effective) and observation group (n=15, ineffective), the effective rate of treatment was statistically analyzed. Visual analogue scale and Japanese orthopaedic association scores were compared before surgery, 3 mo after surgery and 6 mo after surgery. The influencing factors of lumbar disc herniation treatment effect were analyzed. The effective rate of lumbar disc herniation patients treated by percutaneous transforaminal endoscopic lumbar discectomy surgery was 85.00 %. Compared with that before surgery, the visual analogue scale score of lumbar disc herniation patients was significantly decreased 3 mo after surgery and 6 mo after surgery, but the Japanese orthopaedic association score was significantly increased (p<0.05). In logistics regression analysis, it was found that the course of disease, history of trauma and degree of lumbago were the main factors affecting the therapeutic efficacy of percutaneous transforaminal endoscopic surgery in patients with lumbar disc herniation. There are many factors influencing the efficacy of percutaneous transforaminal endoscopic surgery for lumbar disc herniation patients and the relationship between them and the therapeutic effect should be comprehensively analyzed.

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Section: Resultssupporting

confidence: 93%

Analysis of Influencing Factors on Short-Term Efficacy of Percutaneous Transforaminal Endoscopic Lumbar Discectomy in the Treatment of Lumbar Disc Herniation

Duan¹,

Zhang²,

Ren³

et al. 2021

ijps

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“…VTT was previously reported to predict a worse outcome for a pelvic osteosarcoma 17,18 . In our study, it was associated with shorter overall survival (21.5 versus 54.0 months), recurrence-free survival (18.6 versus 32.4 months), and metastasisfree survival (11.2 versus 41.0 months) in patients with localized disease.…”

Section: Prognosis Of Pelvic Sarcomas With Vtt At Presentationmentioning

confidence: 94%

“…For the cases of VTT without pathological confirmation, the diagnosis was based on published radiographic criteria: (1) absence of a flowing void effect within the vein on T2-weighted MRI and a filling defect within the vein on enhanced CT/MRI; (2) calcification, or fillings within the vein with the same imaging characteristics as the primary tumor; (3) dilated caliber of the vein; (4) "thread and streaks" sign, or streak-like enhancement within the vein; or (5) high metabolic activity within the vein on an 18 FDG (fluorodeoxyglucose) PET/CTscan. The presentation of (2) through ( 5) above was helpful for differential diagnosis from benign thrombus (see Appendix Table S1) 17,18 . We proposed a classification system (the Peking University People's Hospital [PKUPH] system) for VTT in pelvic sarcomas (Fig.…”

Section: Data Collectionmentioning

confidence: 99%

“…The occurrence of a venous tumor thrombus (VTT) in a pelvic sarcoma presents serious challenges because it usually confers greater difficulties with resection, an intralesional margin within the vein, and higher risks of recurrence and distant metastasis [11][12][13][14][15][16][17][18] . As a result, a VTT in a pelvic sarcoma may be a contraindication to an attempt at wide resection.…”

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confidence: 99%

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Venous Tumor Thrombus in Primary Bone Sarcomas in the Pelvis

Liang

Guo

Tang

et al. 2021

Journal of Bone and Joint Surgery

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Background:Few investigations of venous tumor thrombus (VTT) in primary pelvic bone sarcomas are available. We aimed to identify the prevalence, associated factors, and prognosis of VTT across different types of pelvic sarcomas and to propose an algorithm for management.Methods:We included 451 consecutive cases of primary, bone-derived, treatment-naive, pelvic sarcomas in this study. Demographic data and the results of initial laboratory tests, imaging examinations, and oncological evaluations were extracted and analyzed. Forty-four cases of VTT were diagnosed with radiographic examinations, and 18 of them were verified histologically.Results:The cohort consisted of chondrosarcomas (41.2%), osteosarcomas (30.4%), Ewing sarcomas (15.5%), bone-derived undifferentiated pleomorphic sarcomas (5.8%), and other bone sarcomas (7.1%). The prevalence of VTT was 9.8% in the whole group, and associated factors included a lactate dehydrogenase (LDH) level of ≥230.5 U/L and invasion of the L5-S1 intervertebral foramen. Patients with pelvic osteosarcoma had a high prevalence of VTT (22.6%), and the associated factors in this group included a chondroblastic subtype, an LDH level of ≥187 U/L, and invasion of the obturator foramen and the L5-S1 intervertebral foramen. Patients with VTT had a poor prognosis with a median overall survival time of 14 months. Subgroup analyses of localized pelvic osteosarcoma indicated that the presence of VTT decreased the median overall survival time (21.5 versus 54.0 months for those without VTT, p = 0.003), median recurrence-free survival time (18.6 versus 32.4 months, p = 0.020), and median metastasis-free survival time (11.2 versus 41.0 months, p < 0.001).Conclusions:VTT is most common in patients with pelvic osteosarcoma as compared with patients with other primary bone sarcomas, and it is associated with several factors. It is a negative prognostic factor. An algorithm for management of pelvic sarcomas with VTT stratified by the classification of the VTT might be beneficial, but further validation is necessary.Level of Evidence:Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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“…The standard treatment for OS is still surgery combined with chemotherapy and neoadjuvant chemotherapy ( 7 ). Furthermore, the clinical outcomes of OS and ES in the pelvis and sacrum have been shown to be inferior to those in other sites due to the larger sizes of the lesions when found and the difficulty in obtaining a wide surgical resection margin ( 5 , 8 , 9 ). Clinically, an auxiliary diagnostic tool is needed to improve the accuracy of distinguishing OS from ES to promptly formulate individualized treatment plans ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

The potential for different computed tomography-based machine learning networks to automatically segment and differentiate pelvic and sacral osteosarcoma from Ewing’s sarcoma

Yin¹,

Wang²,

Wang³

et al. 2023

Quant Imaging Med Surg

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Background: This study aimed to explore optimal computed tomography (CT)-based machine learning and deep learning methods for the identification of pelvic and sacral osteosarcomas (OS) and Ewing's sarcomas (ES).Methods: A total of 185 patients with pathologically confirmed pelvic and sacral OS and ES were analyzed.We first compared the performance of 9 radiomics-based machine learning models, 1 radiomics-based convolutional neural networks (CNNs) model, and 1 3-dimensional (3D) CNN model, respectively. We then proposed a 2-step no-new-Net (nnU-Net) model for the automatic segmentation and identification of OS and ES. The diagnoses by 3 radiologists were also obtained. The area under the receiver operating characteristic curve (AUC) and accuracy (ACC) were used to evaluate the different models.Results: Age, tumor size, and tumor location showed significant differences between OS and ES (P<0.01).For the radiomics-based machine learning models, logistic regression (LR; AUC =0.716, ACC =0.660) performed best in the validation set. However, the radiomics-based CNN model had an AUC of 0.812 and ACC of 0.774 in the validation set, which were higher than those of the 3D CNN model (AUC =0.709, ACC =0.717). Among all the models, the nnU-Net model performed best, with an AUC of 0.835 and an ACC of 0.830 in the validation set, which was significantly higher than the primary physician's diagnosis (ACCs ranged from 0.757 to 0.811) (P<0.01). Conclusions:The proposed nnU-Net model could be an end-to-end, non-invasive, and accurate auxiliary diagnostic tool for the differentiation of pelvic and sacral OS and ES.

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Radiological characteristics and predisposing factors of venous tumor thrombus in pelvic osteosarcoma: A mono‐institutional retrospective study of 115 cases

Cited by 5 publications

References 33 publications

Analysis of Influencing Factors on Short-Term Efficacy of Percutaneous Transforaminal Endoscopic Lumbar Discectomy in the Treatment of Lumbar Disc Herniation

Analysis of Influencing Factors on Short-Term Efficacy of Percutaneous Transforaminal Endoscopic Lumbar Discectomy in the Treatment of Lumbar Disc Herniation

Venous Tumor Thrombus in Primary Bone Sarcomas in the Pelvis

The potential for different computed tomography-based machine learning networks to automatically segment and differentiate pelvic and sacral osteosarcoma from Ewing’s sarcoma

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