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Ban Y, Hoshi M, Oebisu N, Orita K, Iwai T, Yao H, Nakamura H. Anti-Tumor Effect and Neurotoxicity of Ethanol Adjuvant Therapy after Surgery of a Soft Tissue Sarcoma. Curr Oncol 2023; 30:5251-5265. [PMID: 37366882 DOI: 10.3390/curroncol30060399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Wide resection is the main treatment for sarcomas; however, when they are located near major nerves, their sacrifices might affect limb function. The efficacy of ethanol adjuvant therapy for sarcomas has not been established. In this study, the anti-tumor effect of ethanol, as well as its neurotoxicity, were assessed. In vitro anti-tumor effect of ethanol as evaluated using MTT, wound healing, and invasion assays on a synovial sarcoma cell line (HS-SY-II). In vivo, an assessment was conducted in nude mice (implanted with subcutaneous HS-SY-II) treated with different ethanol concentrations after surgery with a close margin. Sciatic nerve neurotoxicity was assessed with electrophysiological and histological examination. In vitro, ethanol concentrations at 30% and higher showed cytotoxic effects in MTT assay and markedly reduced migration and invasive ability of HS-SY-II. In vivo, both 30% and 99.5% ethanol concentrations, compared to 0% concentration, significantly reduced the local recurrence. However, in the group treated with 99.5% ethanol, nerve conduction tests showed prolonged latency and decreased amplitude, and morphological changes suggestive of nerve degeneration were observed in the sciatic nerve, while the 30% ethanol did not cause neurological damage. In conclusion, 30% is the optimal concentration for ethanol adjuvant therapy after close-margin surgery for sarcoma.
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Affiliation(s)
- Yoshitaka Ban
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-ku, Osaka 545-8585, Japan
| | - Manabu Hoshi
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-ku, Osaka 545-8585, Japan
| | - Naoto Oebisu
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-ku, Osaka 545-8585, Japan
| | - Kumi Orita
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-ku, Osaka 545-8585, Japan
| | - Tadashi Iwai
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-ku, Osaka 545-8585, Japan
| | - Hana Yao
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-ku, Osaka 545-8585, Japan
| | - Hiroaki Nakamura
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-ku, Osaka 545-8585, Japan
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Mechanisms of Cytotoxicity of Chemical Agents to Giant Cell Tumors: An In Vitro Study. Stem Cells Int 2020; 2020:8827192. [PMID: 32952568 PMCID: PMC7481941 DOI: 10.1155/2020/8827192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/02/2020] [Accepted: 08/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background Various chemical agents have been used as an adjuvant treatment for giant cell tumor (GCT). However, the comparative effect of these chemicals remains unclear. Methods Multinucleated and spindle cells from cultured GCT patients, characterized by Nanog and Oct4 expression with RT-PCR, were directly administered, in vitro, with concentrations of 1%, 3%, and 5% of H2O2 and 75%, 85%, and 95% of ethanol for 10 minutes and concentrations of 0.003%, 0.005%, 0.01%, 0.03%, 0.1%, and 0.3% of H2O2 for 5 minutes and were incubated for 24 hours. Cell morphology, cell viability, and flow cytometry after various concentrations of H2O2 and ethanol exposure were assessed. Results H2O2 in all concentrations caused loss of cell viability. The number of viable cells after H2O2 exposure was related to the concentration-dependent effect. The initial viable spindle-shaped cell, multinucleated giant cell, and round-epithelioid cell had morphological changes into fragmented nonviable cells after exposure to H2O2. Flow cytometry using Annexin V showed cell death due to necrosis, with the highest concentration amounting to 0.3%. Conclusion Administering local chemical adjuvants of H2O2 in vitro caused loss of viable GCT cells. The number of viable cells after H2O2 exposure was related to the concentration-dependent effect, whereas reducing concentration of H2O2 may cause loss of viability and morphology of cultured GCT cells with the apoptotic mechanism.
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Huang H, Li Y, Wu M, Luo J, Nie J, Hou B, He Q, Diao Y, Qi L, Zhao Y, Liu Y, Yang D, Zhou L. Effects of ethanol on the anticancer function of doxorubicin in JJ012 cells. Future Oncol 2018; 14:1285-1297. [PMID: 29774752 DOI: 10.2217/fon-2017-0547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Chondrosarcoma is difficult to treat because of resistance to conventional chemotherapy and radiotherapy. This study evaluated the effects of ethanol in combination with doxorubicin in chondrosarcoma cells. MATERIALS & METHODS JJ012, was treated with doxorubicin alone or in combination with ethanol. Effects on cellular proliferation, migration, invasion, apoptosis, and the cell cycle were evaluated. RESULTS Treatment of JJ012 cells with 100 mM ethanol and doxorubicin resulted in reduced cell growth, invasion, and migration. In addition, doxorubicin uptake into the nucleus was enhanced and p53 mRNA expression was upregulated in JJ012 cells. CONCLUSION Ethanol combined with doxorubicin increased doxorubicin uptake in the nucleus and enhanced the effects of doxorubicin in JJ012 cells.
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Affiliation(s)
- Hui Huang
- Department of Biochemistry & Molecular Biology, Harbin Medical University, Harbin, PR China.,Translational Medicine Center of Northern China, Harbin Medical University, Harbin, PR China.,Basic Medical Institute of Heilongjiang Medical Science Academy, Harbin, PR China.,Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, PR China
| | - Yanze Li
- Department of Biochemistry & Molecular Biology, Harbin Medical University, Harbin, PR China.,Translational Medicine Center of Northern China, Harbin Medical University, Harbin, PR China.,Basic Medical Institute of Heilongjiang Medical Science Academy, Harbin, PR China.,Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, PR China
| | - Mingjuan Wu
- Heilongjiang Academy of Traditional Chinese Medicine, Harbin, PR China
| | - Jing Luo
- Department of Biochemistry & Molecular Biology, Harbin Medical University, Harbin, PR China.,Translational Medicine Center of Northern China, Harbin Medical University, Harbin, PR China
| | - Junhui Nie
- Department of Biochemistry & Molecular Biology, Harbin Medical University, Harbin, PR China.,Translational Medicine Center of Northern China, Harbin Medical University, Harbin, PR China
| | - Baoyu Hou
- Department of Biochemistry & Molecular Biology, Harbin Medical University, Harbin, PR China.,Translational Medicine Center of Northern China, Harbin Medical University, Harbin, PR China
| | - Qi He
- Department of Biochemistry & Molecular Biology, Harbin Medical University, Harbin, PR China.,Translational Medicine Center of Northern China, Harbin Medical University, Harbin, PR China
| | - Yan Diao
- Department of Biochemistry & Molecular Biology, Harbin Medical University, Harbin, PR China.,Translational Medicine Center of Northern China, Harbin Medical University, Harbin, PR China
| | - Lin Qi
- Department of Radioimmunossay, Heilongjiang Province Hospital, Harbin, PR China
| | - Yuanyuan Zhao
- Department of Anesthesiology, Heilongjiang Province Hospital, Harbin, PR China
| | - Ying Liu
- Department of Gastroenterology, Heilongjiang Province Hospital, Harbin, PR China
| | - Dan Yang
- Department of Biochemistry & Molecular Biology, Harbin Medical University, Harbin, PR China.,Translational Medicine Center of Northern China, Harbin Medical University, Harbin, PR China.,Basic Medical Institute of Heilongjiang Medical Science Academy, Harbin, PR China.,Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, PR China
| | - Lingyun Zhou
- Department of Biochemistry & Molecular Biology, Harbin Medical University, Harbin, PR China.,Translational Medicine Center of Northern China, Harbin Medical University, Harbin, PR China.,Basic Medical Institute of Heilongjiang Medical Science Academy, Harbin, PR China.,Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, PR China
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Verdegaal SHM, van Rijswijk CS, Brouwers HFC, Dijkstra PDS, van de Sande MAJ, Hogendoorn PCW, Taminiau AHM. MRI appearances of atypical cartilaginous tumour/grade I chondrosarcoma after treatment by curettage, phenolisation and allografting: recommendations for follow-up. Bone Joint J 2017; 98-B:1674-1681. [PMID: 27909131 DOI: 10.1302/0301-620x.98b12.36970] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 07/19/2016] [Indexed: 11/05/2022]
Abstract
AIMS The purpose of this retrospective study was to differentiate between the MRI features of normal post-operative change and those of residual or recurrent disease after intralesional treatment of an atypical cartilage tumour (ACT)/grade I chondrosarcoma. PATIENTS AND METHODS We reviewed the case notes, radiology and histology of 75 patients, who had been treated for an ACT/grade I chondrosarcoma by curettage, phenolisation and bone allografting between 1994 and 2005. The first post-operative Gd-enhanced MRI scan was carried out within one year of surgery. Patients had a minimum of two scans and a mean follow-up of 72 months (13 to 169). Further surgery was undertaken in cases of suspected recurrence. RESULTS In 14 patients (18.6%) a second procedure was undertaken after a mean period of 59 months (8 to 114). Radio frequency ablation (RFA) was used in lesions of < 10 mm and curettage, phenolisation and bone grafting for those ≥ 10 mm. Only six of these (8% of total) had a histologically-proven recurrence. No increase in tumour grade was seen at time of recurrence. CONCLUSION Based on this study, we have been able to classify the post-operative MRI appearances into four groups. These groups differ in follow-up, and have a different risk of recurrence of the lesion. Follow-up and treatment vary for the patients in each group. We present a flow diagram for the appropriate and safe follow-up for this specific group of patients. Cite this article: Bone Joint J 2016;98-B:1674-81.
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Affiliation(s)
- S H M Verdegaal
- Alrijne Hospital, Simon Smitweg 1 2353 GA, Leiderdorp, The Netherlands
| | - C S van Rijswijk
- Leiden University Medical Center, P.O. Box 9600, L-1-Q, Albinusdreef 2, 2300 RC Leiden, 2300 RC, The Netherlands
| | - H F C Brouwers
- University Medical Center Groningen, Hanzeplein 1 9713 GZ, Groningen, The Netherlands
| | - P D S Dijkstra
- Leiden University Medical Center, P.O. Box 9600, L-1-Q, Albinusdreef 2, 2300 RC Leiden, 2300 RC, The Netherlands
| | - M A J van de Sande
- Leiden University Medical Center, P.O. Box 9600, L-1-Q, Albinusdreef 2, 2300 RC Leiden, 2300 RC, The Netherlands
| | - P C W Hogendoorn
- Leiden University Medical Center, P.O. Box 9600, L-1-Q, Albinusdreef 2, 2300 RC Leiden, 2300 RC, The Netherlands
| | - A H M Taminiau
- Leiden University Medical Center, P.O. Box 9600, L-1-Q, Albinusdreef 2, 2300 RC Leiden, 2300 RC, The Netherlands
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Dierselhuis EF, Gerbers JG, Ploegmakers JJW, Stevens M, Suurmeijer AJH, Jutte PC. Local Treatment with Adjuvant Therapy for Central Atypical Cartilaginous Tumors in the Long Bones: Analysis of Outcome and Complications in One Hundred and Eight Patients with a Minimum Follow-up of Two Years. J Bone Joint Surg Am 2016; 98:303-13. [PMID: 26888678 DOI: 10.2106/jbjs.o.00472] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND A central atypical cartilaginous tumor (ACT)--formerly known as chondrosarcoma grade 1 (CS1)--is a tumor of intermediate-type malignancy, often treated with surgery. The extent of surgery remains controversial, as some advocate resection and others favor local treatment by curettage. Because of the low prevalence of ACT/CS1, the available data are limited and generally not uniform. The purpose of this study was to present the outcome for a large cohort of patients with ACT/CS1 in the long bones who were treated with curettage and adjuvant phenolization and followed for a minimum of two years according to national guidelines. METHODS A retrospective study was designed to analyze data from 108 patients treated for central ACT/CS1 in the long bones between 2006 and 2012. All patients were treated with curettage and adjuvant phenolization, and defects were filled with polymethylmethacrylate, bone graft, or bone substitutes. The primary end point was local recurrence or residual tumor. Secondary end points included the type and rate of complications and reoperations. RESULTS All patients were free from local recurrence at a mean follow-up of 48.7 months (range, 24.3 to 97.5 months). Residual tumor was suspected in five patients, leading to a 95.4% disease-free survival rate. A fracture occurred in eleven patients (10.2%). Other complications were osseous penetration during the surgery (two patients), wound infection (one patient), arthrofibrosis (one patient), and skin necrosis (one patient). Tumor volume was related neither to the risk of fracture nor to the occurrence of residual tumor. CONCLUSIONS In our experience, curettage of ACT/CS1 in the long bones with adjuvant phenolization is safe, even with large tumors of up to 100 cm(3). Most worrisome is the risk of fracture, which occurred in 10.2% of our patients. Considering the relatively mild behavior of ACT/CS1, less aggressive treatment, by observation or by minimally invasive surgery, could be the next step that should be evaluated prospectively.
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Affiliation(s)
- Edwin F Dierselhuis
- Departments of Orthopedics (E.F.D., J.G.G., J.J.W.P., M.S., and P.C.J.) and Pathology (A.J.H.S.), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jasper G Gerbers
- Departments of Orthopedics (E.F.D., J.G.G., J.J.W.P., M.S., and P.C.J.) and Pathology (A.J.H.S.), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Joris J W Ploegmakers
- Departments of Orthopedics (E.F.D., J.G.G., J.J.W.P., M.S., and P.C.J.) and Pathology (A.J.H.S.), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Martin Stevens
- Departments of Orthopedics (E.F.D., J.G.G., J.J.W.P., M.S., and P.C.J.) and Pathology (A.J.H.S.), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Albert J H Suurmeijer
- Departments of Orthopedics (E.F.D., J.G.G., J.J.W.P., M.S., and P.C.J.) and Pathology (A.J.H.S.), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands Dutch National Bone Tumor Committee, Leiden, the Netherlands
| | - Paul C Jutte
- Departments of Orthopedics (E.F.D., J.G.G., J.J.W.P., M.S., and P.C.J.) and Pathology (A.J.H.S.), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands Dutch National Bone Tumor Committee, Leiden, the Netherlands
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Kim W, Han I, Kim EJ, Kang S, Kim HS. Outcomes of curettage and anhydrous alcohol adjuvant for low-grade chondrosarcoma of long bone. Surg Oncol 2015; 24:89-94. [PMID: 25912950 DOI: 10.1016/j.suronc.2015.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 03/02/2015] [Accepted: 04/04/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Low-grade chondrosarcoma of long bones can be treated successfully with extended intralesional curettage using adjuvants. However, there is no study reporting the use of anhydrous alcohol as an adjuvant in the treatment of low-grade chondrosarcoma. We asked (1) whether intralesional curettage and anhydrous alcohol adjuvant for low-grade chondrosarcoma is associated with good oncologic outcomes; and we report (2) the complications of the procedure. METHODS Thirty-six patients (13 men, 23 women) with a mean age of 46 years (range, 18-67 years) were treated for low-grade chondrosarcoma and followed up for a median of 62 months (range, 24-169 months). After intralesional curettage, and additional burring, anhydrous alcohol was used as an adjuvant therapy. RESULTS At the time of last follow-up, there were no local recurrences or distant metastases. Six patients developed complications: 4 postoperative fractures (11%), 1 intra-articular loose body (3%) and 1 postoperative joint stiffness (3%). CONCLUSION Anhydrous alcohol is a reasonable adjuvant for the curettage of low-grade chondrosarcoma of long bones. A long-term follow-up study is necessary, considering the slow biological progression of low-grade chondrosarcoma.
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Affiliation(s)
- Wanlim Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, South Korea.
| | - Ilkyu Han
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, South Korea; Musculoskeletal Tumor Center, Seoul National University Cancer Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, South Korea.
| | - Eo Jin Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, South Korea.
| | - Seungcheol Kang
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, South Korea.
| | - Han-Soo Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, South Korea; Musculoskeletal Tumor Center, Seoul National University Cancer Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, South Korea.
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Surgical treatment of central grade 1 chondrosarcoma of the appendicular skeleton. J Orthop Traumatol 2013; 14:101-7. [PMID: 23462877 PMCID: PMC3667363 DOI: 10.1007/s10195-013-0230-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 01/31/2013] [Indexed: 11/21/2022] Open
Abstract
Background Diagnosis and treatment of low-grade chondrosarcoma remain controversial. We performed a review of a single-center series with the aims of assessing the oncologic outcome of these patients, verifying if intralesional curettage can be adequate treatment, and defining clinical criteria to support the surgeon and the oncologist in decision-making for surgery and subsequent follow-up. Materials and methods A retrospective review of 85 patients was performed (61 females and 24 males, age range 20–76 years). The site of the lesion was the femur in 35 cases, humerus in 33, tibia in 15, and fibula in 2. Sixty-four patients were treated by intralesional curettage. Twenty-one patients with aggressive radiological patterns were treated with wide resection. Results Mean follow-up was 67 months (range 24–206 months). Two patients developed local recurrence, both after intralesional curettage. The difference in incidence of recurrence was not statistically significant between the two groups. No distant metastases were observed. Postsurgical complications were significantly higher in the resection group. Conclusions Low-grade chondrosarcoma of the appendicular skeleton without aggressive radiological patterns can be treated with intralesional surgery with good oncological outcome and very low rate of postsurgical complications. Wide resection, following surgical principles of malignant bone tumors, should be considered only when aggressive biologic behavior is evident on imaging.
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Angelini A, Guerra G, Mavrogenis AF, Pala E, Picci P, Ruggieri P. Clinical outcome of central conventional chondrosarcoma. J Surg Oncol 2012; 106:929-37. [PMID: 22649023 DOI: 10.1002/jso.23173] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 05/07/2012] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Aim of this study was to analyze (1) survival, local recurrence (LR), and metastasis rates between the three histological tumor grades; (2) whether type of treatment and tumor site influenced prognosis for each histologic grade. METHODS We retrospectively studied 296 patients with central conventional chondrosarcomas (CS) (87 grade 1, 162 grade 2, and 47 grade 3). The femur was the most common site (91 cases), followed by the pelvis (82) and other less frequent sites. Type of surgery was related with histologic grade. Margins were wide in 222 cases, marginal in 23, and intralesional in 51 cases. RESULTS At a mean of 7 years, 201 patients remained continuously NED, 33 were NED after treatment of relapse, 15 were AWD, 35 were died of disease, and 12 of other causes. Survival was 92% at 5 years and 84% at 10 years, significantly influenced by histological grading. In grade 3 CS, two factors influenced survival: type of surgery (resection vs. amputation, P = 0.051) and site (P = 0.039). The two significant factors lost their significance at multivariate analysis. CONCLUSION Central conventional CS with low/intermediate grade has a good prognosis, while high-grade tumors have poor outcome. Tumor relapses are strictly related with histologic grade.
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Affiliation(s)
- Andrea Angelini
- IV Department of Orthopaedics, University of Bologna, Istituto Ortopedico Rizzoli, Bologna, Italy
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Verdegaal SH, Hartigh JD, Hogendoorn PC, Brouwers HF, Taminiau AH. Phenol levels during intralesional curettage and local adjuvant treatment of benign and low-grade malignant bone tumours. Clin Sarcoma Res 2012; 2:10. [PMID: 22588078 PMCID: PMC3351749 DOI: 10.1186/2045-3329-2-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 03/26/2012] [Indexed: 11/13/2022] Open
Abstract
Background Phenol is widely used for years as local adjuvant treatment for bone tumours. Despite its use for a long time, no information is available about the local concentration of phenol that is achieved in an individual patient, and the most sufficient and safe procedure to wash out the phenol after using it as local adjuvant. Questions/purposes 1. What is the initial local concentration of phenol in the tissue of the cavity wall after the application of phenol? 2. How quickly is phenol 85% diluted by washing the bone cavity with ethanol 96% solution? 3. Is the degree and speed of dilution influenced by the size of the cavity? 4. How many times should the cavity be rinsed to obtain sufficient elimination of phenol? Methods A basic science study was performed at respectively 16 and 10 patients, treated by intralesional curettage and adjuvant therapy for low-grade central chondrosarcoma of bone. Test 1:in 16 patients ten samples were collected of the mixture of phenol and ethanol from the bone cavity. Test 2:in ten patients, two biopsy samples were taken from the cavity wall in the bone during surgery. Results Phenol concentrations had wide variety in different patients, but all decreased by rinsing with ethanol. Conclusions Ethanol 96% is effective to wash out local applicated phenol, by rinsing the bone cavity six times. The local concentration of phenol diminishes to an acceptable concentration of 0.2%. This study provides new insights to safely further improve the surgical technique of intralesional treatment of bone tumours.
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Affiliation(s)
- Suzan Hm Verdegaal
- Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
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Gortzak Y, Kandel R, Deheshi B, Werier J, Turcotte RE, Ferguson PC, Wunder JS. The efficacy of chemical adjuvants on giant-cell tumour of bone. An in vitro study. ACTA ACUST UNITED AC 2010; 92:1475-9. [PMID: 21089702 DOI: 10.1302/0301-620x.92b10.23495] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Various chemicals are commonly used as adjuvant treatment to surgery for giant-cell tumour (GCT) of bone. The comparative effect of these solutions on the cells of GCT is not known. In this study we evaluated the cytotoxic effect of sterile water, 95% ethanol, 5% phenol, 3% hydrogen peroxide (H(2)O(2)) and 50% zinc chloride (ZnCI(2)) on GCT monolayer tumour cultures which were established from six patients. The DNA content, the metabolic activity and the viability of the cultured samples of tumour cells were assessed at various times up to 120 hours after their exposure to these solutions. Equal cytotoxicity to the GCT monolayer culture was observed for 95% ethanol, 5% phenol, 3% H(2)O(2) and 50% ZnCI(2). The treated samples showed significant reductions in DNA content and metabolic activity 24 hours after treatment and this was sustained for up to 120 hours. The samples treated with sterile water showed an initial decline in DNA content and viability 24 hours after treatment, but the surviving cells were viable and had proliferated. No multinucleated cell formation was seen in these cultures. These results suggest that the use of chemical adjuvants other than water could help improve local control in the treatment of GCT of bone.
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Affiliation(s)
- Y Gortzak
- Mount Sinai Hospital, Toronto, Canada.
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