Tumor Volume Increase During Preoperative Chemotherapy as a Novel Predictor of Local Recurrence in Extremity Osteosarcoma

Song, Won Seok; Jeon, Dae‐Geun; Kong, Chang-Bae; Cho, Wan Hyeong; Koh, Jae-Soo; Lee, Jun Ah; Yoo, Ji Young; Jung, Sung Taek; Shin, Duk Seop; Lee, Soo-Yong

doi:10.1245/s10434-010-1536-8

Cited by 18 publications

(20 citation statements)

References 32 publications

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“…Tumor volumes after treatment were divided by volumes before chemotherapy and are expressed as tumor-volume-reduction ratios (TVRs). 10 During the exponential growth phase, the tumor-volume-doubling time (Td) was calculated using the following formula 11 : Td = t × [log 2/(log Vb -log Va)], where Va is tumor volume at initial and Vb that at t days after Va.…”

Section: Tumor Model and Experiments Protocolmentioning

confidence: 99%

The preparation and characterization of gold-conjugated polyphenol nanoparticles as a novel delivery system

Hsieh

Lu²,

Chen³

et al. 2012

IJN

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Nanogold particles are commonly used in nanomedicine. We generated physical nanogold (pNG) conjugated with different ratios of epigallocatechin-3-gallate (EGCG) and evaluated its physicochemical properties, antioxidant activity, and cytotoxicity in vitro as well as anticancer activity in vivo. Results showed that the EGCG-pNG conjugates were successfully prepared at ratios between 23:1 and 23:5, with the percentage of EGCG content increasing with the EGCG:pNG ratio from 23:1 (2.0% ± 0.02%) to 23:5 (28% ± 0.3%). EGCG-pNG particles at ratios of 23:1 and 23:5 demonstrated significantly decreased size from 500 to 20 nm and decreasing zeta potentials of 21 mV to -22 mV, respectively. At a ratio of 23:2.5, the EGCGpNG particles (27% EGCG, 50 nm in size, zeta potential of -8 mV) showed longer EGCG activity half-life (110 days vs 5 hours), controlled release (2 hours vs 30 minutes), and higher antioxidant activity (four times), as well as inhibition of tumor cell growth, than controls. The present study indicated that EGCG-pNG possesses promising therapeutic potential, based on its strong free-radical scavenging and anticancer activities.

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Section: Tumor Model and Experiments Protocolmentioning

confidence: 99%

The preparation and characterization of gold-conjugated polyphenol nanoparticles as a novel delivery system

Hsieh

Lu²,

Chen³

et al. 2012

IJN

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“…Recently, we reported that an increase in tumor volume (TV) during preoperative chemotherapy is related with poor histologic responses and it also is a novel predictor of LR in extremity osteosarcoma 9). Furthermore, subsequently performed cohort and case-control survival analysis between patients with LR and without LR suggested that LR has only a small effect on survivals among patients showing resistance to chemotherapy 10).…”

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confidence: 99%

Role of Surgical Margin on Local Recurrence in High Risk Extremity Osteosarcoma: A Case-Controlled Study

Jeon¹,

Song²,

Kong³

et al. 2013

Clin Orthop Surg

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BackgroundThe relationship between surgical margin and local recurrence (LR) in osteosarcoma patients with poor responses to chemotherapy is unclear. Moreover, the incidences of LR according to three different resection planes (bone, soft tissue, and perineurovascular) are not commonly known.MethodsWe evaluated the incidence of LR in three areas. To assess whether there is a role of surgical margin on LR in patients resistant to preoperative chemotherapy, we designed a case (35 patients with LR) and control (70 patients without LR) study. Controls were matched for age, location, initial tumor volume, and tumor volume change during preoperative chemotherapy.ResultsLR occurred at the soft tissues in 18 cases (51.4%), at the perineurovascular tissues in 11 cases (31.4%), and at the bones in six cases (17.2%). The proportion of inadequate perineurovascular margin was higher in the case group than in the control group (p = 0.01). Within case-control group (105 patients), a correlation between each margin status and LR at corresponding area was found in the bone (p < 0.001) and perineurovascular area (p = 0.001).ConclusionsLR is most common in soft tissues. In patients showing similar unfavorable responses to chemotherapy, the losses of perineurovascular fat plane on preoperative magnetic resonance imaging may be a valuable finding in predicting LR.

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“…In a recent study, Song et al . showed that increase in tumor volume during preoperative chemotherapy is a prognostic factor for LR in osteosarcomas 9. However, they also mentioned that poor response to preoperative chemotherapy could also be a reason in their study for higher local relapses in patients with high tumor volume since chemotherapy response is an important prognosticator for local recurrence.…”

Section: Discussionmentioning

confidence: 94%

“…With the same premise, we can conclude that the high volume of initial tumor will also affect the LR rates in osteosarcomas. Studies evaluating high tumor volume as a prognosticator for LR in patients undergoing limb salvage surgeries are few and with conflicting results 789…”

Section: Introductionmentioning

confidence: 99%

High tumor volume and local recurrence following surgery in osteosarcoma: A retrospective study

Poudel

Kumar

Bakhshi

et al. 2014

IJOO

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Background:Osteosarcoma is a high grade malignant, osteoid forming, primary bone tumor affecting the metaphysis of long bones. Local recurrence (LR) in osteosarcomas is a sinister. Theoretically, a high tumor volume at the time of presentation will limit surgical margins, involve vital neurovascular bundles and show poor response to chemotherapy thereby causing high rates of amputations (as against limb salvage surgery) and should be associated with poor survival rates. This study evaluated objectively if high tumor volume is a significant predictor of local recurrence (LR) in operated cases of osteosarcomas.Materials and Methods:Operated cases of osteosarcoma (presenting to the Orthopedic outpatient or the Medical Oncology outpatient between January 1, 2004 and January 1, 2011 were included in the study. Their preoperative clinical data and investigations along with the operative notes were traced from the medical/departmental records. Details of chemotherapy received in the neo-adjuvant and postoperative periods were noted. Besides, all demographic data were also noted. Tumor volume was calculated using the available magnetic resonance images using the formula: ([π/6] × length × width × depth). Post data extraction, patients were divided in two groups, Groups I (without LR) and Group II (with LR).Results:A total of 95 cases of biopsy proven osteosarcomas were identified. Of which 64 were male and 31 females. There were 15 (15.8%) local recurrences. 71% (57/80) patients without LR fell in the age group of 10-20 years, while 66% (10/15) patients with LR were in the age group of 10-20 years. Limb salvage surgery was done in 81.05% (77/95) patients while a total of 18 patients underwent amputation. Of the 80 cases in Group I (without LR), 40 (50%) patients had tumor volume >200 c.c., 30 patients (37.5%) had tumor volume between 50 and 200 c.c. while only 10 patients had tumor volumes <50 c.c. This was in contrast to the tumor volume noted in Group II (with LR) of 15 patients where 8 patients had a tumor volume between 50 and 200 c.c., five had bigger tumor volumes of >200 c.c. and only two patients were smaller in size, with a tumor volume <50 c.c. The mean tumor volume in the group without LR was 406.74 ± 771.67 c.c. as compared with 195.77 ± 226.8 c.c. in the group with local recurrence. Using Mann-Whitney test, the difference between the two groups was found to be statistically insignificant (P = 1.403).Conclusions:We conclude that high tumor volume is not a significant predictor of LR in osteosarcomas thus patients with high tumor masses should not be denied limb salvage. However, we recommend that the decision on attempting limb salvage should not only be based on the tumor volume alone.

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Tumor Volume Increase During Preoperative Chemotherapy as a Novel Predictor of Local Recurrence in Extremity Osteosarcoma

Abstract: A TVR increase during preoperative chemotherapy could be used to predict patients at high risk of LR. This finding might be useful when considering surgical options to decrease the risk of LR.

Cited by 18 publications

References 32 publications

The preparation and characterization of gold-conjugated polyphenol nanoparticles as a novel delivery system

The preparation and characterization of gold-conjugated polyphenol nanoparticles as a novel delivery system

Role of Surgical Margin on Local Recurrence in High Risk Extremity Osteosarcoma: A Case-Controlled Study

High tumor volume and local recurrence following surgery in osteosarcoma: A retrospective study

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