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Xie T, Feng W, He M, Zhan X, Liao S, He J, Qin Z, Li F, Xu J, Liu Y, Wei Q. Analysis of scRNA-seq and bulk RNA-seq demonstrates the effects of EVI2B or CD361 on CD8 + T cells in osteosarcoma. Exp Biol Med (Maywood) 2023; 248:130-145. [PMID: 36511103 PMCID: PMC10041056 DOI: 10.1177/15353702221142607] [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: 12/15/2022] Open
Abstract
Osteosarcoma (OS) is a common primary malignant tumor of the bone in children and adolescents. The five-year survival rate is estimated to be ~70% based on the currently available treatment modalities. It is well known that tumor-infiltrating immune cells (TIICs) that are the most important components in the tumor microenvironment can exert a killing effect on tumor cells. Therefore, in the present study, 85 RNA-sequencing OS samples were categorized into high- and low-immune score groups with ESTIAMATE. Based on the immune score groups, 474 differentially expressed genes (DEGs) were acquired using the LIMMA package of R language. Subsequently, 86 DEGs were taken through univariate COX regression analysis, of which 14 were screened out by least absolute shrinkage and selection operator regression analysis. Furthermore, multivariate COX regression analysis was performed to obtain 4 DEGs. Finally, ecotropic virus integration site 2B (EVI2B) or CD361 gene was screened out via Kaplan-Meier analysis. In addition, CIBERSORT algorithm was used to evaluate the proportion of 22 kinds of TIICs in OS. Correlation analysis revealed that the high expression level of EVI2B can elevate the infiltrated proportion of CD8+ T cells. Moreover, analysis of single cell RNA-sequencing transcriptome datasets and immunohistochemical staining uncovered that EVI2B was mainly expressed on CD8+ T cells and that EVI2B could promote the expression of granzyme A and K of CD8+ T cells to exhibit a potent killing effect on tumor cells. Therefore, EVI2B was identified as a protective immune-related gene and contributed to good prognosis in OS patients.
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Affiliation(s)
- Tianyu Xie
- Department of Traumatic Orthopaedic, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Wenyu Feng
- Department of Orthopaedic, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, China
| | - Mingwei He
- Department of Traumatic Orthopaedic, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Xinli Zhan
- Department of Spine and Bone Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Shijie Liao
- Department of Traumatic Orthopaedic, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Juliang He
- Department of Bone and Soft Tissue, Affiliated Tumour Hospital of Guangxi Medical University, Nanning 530021, China
| | - Zhaojie Qin
- Department of Spine and Bone Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Feicui Li
- Department of Spine and Bone Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Jiake Xu
- School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia
| | - Yun Liu
- Department of Spine and Bone Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Qingjun Wei
- Department of Traumatic Orthopaedic, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
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Perioperative blood loss after embolization of hypervascular musculoskeletal tumors outside of the spine: A single-center ten year experience and systematic review of the literature. Clin Imaging 2021; 79:24-29. [PMID: 33866111 DOI: 10.1016/j.clinimag.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate outcomes following trans-arterial embolization of hypervascular appendicular bony tumors in patients undergoing orthopedic resection by performing a systematic review including data from the authors' institution. MATERIALS AND METHODS From April 2008 to August 2018, 73 patients (59 males, mean age 58.1 years) with musculoskeletal tumors presented for embolization for preoperative devascularization prior to orthopedic surgery. A retrospective chart review was performed to identify demographic, procedural and surgical data. A systematic review of the Pubmed, Medline, and Web of Science databases was performed to identify studies in which pre-operative embolization was performed of appendicular MSK tumors, and with measurements of estimated blood loss. All the variables listed above were recorded. A patient level analysis was performed to determine average estimated blood loss. RESULTS 58 patients (47 men, 11 women, range 21-84 years) were included in our institutional analysis. The median EBL was 500 mL (range 100-3000). There was no difference in EBL between RCC (719.6 ± 626.1) and non-RCC groups (855.6 ± 657.5); p = 0.44. The median intra-operative transfusion requirement was 1.0 unit (range 0-8 ± 2.06). From 1984 to 2015, 9 studies were identified that provided data for a total of 118 patients (46 males, 42 females, range 10-82 years). The mean and median post-surgical EBL across all patients was 976.9 ± 78.5 (SE) and 725 mL (range 10-7000), respectively. There were no complications related to non-target embolization. CONCLUSION Preoperative trans-arterial embolization of hypervascular MSK neoplasms appears to be safe and effective in minimizing peri- and post-operative bleeding while keeping transfusion requirements low.
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Qu Y, Li X, Yan Z, Zhao L, Zhang L, Liu C, Xie S, Li K, Metaxas D, Wu W, Hao Y, Dai K, Zhang S, Tao X, Ai S. Surgical planning of pelvic tumor using multi-view CNN with relation-context representation learning. Med Image Anal 2021; 69:101954. [PMID: 33550006 DOI: 10.1016/j.media.2020.101954] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/21/2020] [Accepted: 12/28/2020] [Indexed: 12/20/2022]
Abstract
Limb salvage surgery of malignant pelvic tumors is the most challenging procedure in musculoskeletal oncology due to the complex anatomy of the pelvic bones and soft tissues. It is crucial to accurately resect the pelvic tumors with appropriate margins in this procedure. However, there is still a lack of efficient and repetitive image planning methods for tumor identification and segmentation in many hospitals. In this paper, we present a novel deep learning-based method to accurately segment pelvic bone tumors in MRI. Our method uses a multi-view fusion network to extract pseudo-3D information from two scans in different directions and improves the feature representation by learning a relational context. In this way, it can fully utilize spatial information in thick MRI scans and reduce over-fitting when learning from a small dataset. Our proposed method was evaluated on two independent datasets collected from 90 and 15 patients, respectively. The segmentation accuracy of our method was superior to several comparing methods and comparable to the expert annotation, while the average time consumed decreased about 100 times from 1820.3 seconds to 19.2 seconds. In addition, we incorporate our method into an efficient workflow to improve the surgical planning process. Our workflow took only 15 minutes to complete surgical planning in a phantom study, which is a dramatic acceleration compared with the 2-day time span in a traditional workflow.
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Affiliation(s)
- Yang Qu
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Xiaomin Li
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Zhennan Yan
- SenseBrain Technology, Princeton, NJ 08540, USA
| | - Liang Zhao
- SenseTime Research, Shanghai 200233, China
| | - Lichi Zhang
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030 China
| | - Chang Liu
- SenseTime Research, Shanghai 200233, China
| | | | - Kang Li
- Department of Orthopaedics, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
| | - Dimitris Metaxas
- Department of Computer Science, Rutgers University, Piscataway, NJ 08854, USA
| | - Wen Wu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yongqiang Hao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Kerong Dai
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200240, China
| | - Shaoting Zhang
- SenseTime Research, Shanghai 200233, China; Qing Yuan Research Institute, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
| | - Songtao Ai
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
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Zhang Y, Li F, Qiu L, Xu L, Niu X, Sui Y, Zhang S, Zhang Q, Zhang L. Toward Precise Osteotomies: A Coarse-to-Fine 3D Cut Plane Planning Method for Image-Guided Pelvis Tumor Resection Surgery. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:1511-1523. [PMID: 31714218 DOI: 10.1109/tmi.2019.2951838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Surgical resection is the main clinical method for the treatment of bone tumors. A critical procedure for bone tumor resection is to plan a set of cut planes that enable resecting the bone tumor with a safe margin while preserving the maximum amount of healthy bone. Currently, the surgeons rely on manual methods to plan the cut planes, which highly depend on the surgeons' experiences and have been demonstrated to be error-prone, and in turn, increase the recurrence rate or resect much healthy bone. This study targets on improving the precision of cut plane planning for the image guided pelvis tumor resection surgeries. A semi-automatic approach to cut plane planning was proposed via a coarse-to-fine strategy. It can efficiently identify a dangerous region in the 3D space, which contains the bone tumor and its surrounding normal tissue with a safe margin. By projecting the dangerous region into an appropriate 2D space, a segmented boundary-constrained linear regression method was leveraged to plan a set of 3D cut planes that ensure the minimum area of the resected specimen in the 2D space while having the dangerous region cleared. Further, a coarse-to-fine 3D cut plane planning method was developed by incorporating a 3D cut plane refinement scheme with our 2D planning method. Extensive experiments, on the surgical data from nine previous pelvis tumor resection surgeries, demonstrated that our proposed approach substantially improved the localization precision of cut planes ( ) and decreased the amount of resected specimen ( ), as compared to the manual method.
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Lu C, Peng K, Guo H, Ren X, Hu S, Cai Y, Han Y, Ma L, Xu P. miR-18a-5p promotes cell invasion and migration of osteosarcoma by directly targeting IRF2. Oncol Lett 2018; 16:3150-3156. [PMID: 30127908 PMCID: PMC6096157 DOI: 10.3892/ol.2018.9032] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/19/2018] [Indexed: 12/16/2022] Open
Abstract
An increasing number of studies have suggested that microRNAs (miRNAs) are involved in the progress of many human cancers including osteosarcoma (OS). Especially, microRNA-18a-5p (miR-18a-5p) has been reported to associate with the occurrence, development and clinical outcomes of human cancers. Therefore, we investigated the functions of miR-18a-5p in OS. Reverse transcription-quantitative PCR (RT-qPCR) showed that miR-18a-5p was significantly upregulated in OS tissues and cell lines (MG-63 and Saos-2). The overexpression of miR-18a-5p was found to significantly promote cell migration and invasion in MG-63 cells via Transwell assay. Moreover, luciferase reporter assays indicated that interferon regulatory factor (IRF)2 was a direct target of miR-18a-5p. IRF2 was downregulated in MG-63 and Saos-2 cell lines. Furthermore, Transwell analysis showed that the knockout of IRF2 promoted cell migration and invasion in MG-63 cells. Carcinogenesis of miR-18a-5p was reversed by the overexpression of IRF2 in OS. In conclusion, miR-18a-5p promoted the invasion and migration of OS cells through inhibiting IRF2 expression. Thus, miR-18a-5p might act as a potential target for the diagnosis and treatment of OS in the future.
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Affiliation(s)
- Chao Lu
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, Shaanxi 710061, P.R. China
| | - Kan Peng
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, Shaanxi 710061, P.R. China
| | - Hao Guo
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, Shaanxi 710061, P.R. China
| | - Xiaoyu Ren
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, Shaanxi 710061, P.R. China
| | - Shouye Hu
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, Shaanxi 710061, P.R. China
| | - Yuanzhen Cai
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, Shaanxi 710061, P.R. China
| | - Yan Han
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, Shaanxi 710061, P.R. China
| | - Le Ma
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710054, P.R. China
| | - Peng Xu
- Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an, Shaanxi 710061, P.R. China
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Igarashi K, Kawaguchi K, Kiyuna T, Miyake K, Miyake M, Li S, Han Q, Tan Y, Zhao M, Li Y, Nelson SD, Dry SM, Singh AS, Elliott IA, Russell TA, Eckardt MA, Yamamoto N, Hayashi K, Kimura H, Miwa S, Tsuchiya H, Eilber FC, Hoffman RM. Tumor-targeting Salmonella typhimurium A1-R combined with recombinant methioninase and cisplatinum eradicates an osteosarcoma cisplatinum-resistant lung metastasis in a patient-derived orthotopic xenograft (PDOX) mouse model: decoy, trap and kill chemotherapy moves toward the clinic. Cell Cycle 2018; 17:801-809. [PMID: 29374999 DOI: 10.1080/15384101.2018.1431596] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
In the present study, a patient-derived orthotopic xenograft (PDOX) model of recurrent cisplatinum (CDDP)-resistant metastatic osteosarcoma was treated with Salmonella typhimurium A1-R (S. typhimurium A1-R), which decoys chemoresistant quiescent cancer cells to cycle, and recombinant methioninase (rMETase), which selectively traps cancer cells in late S/G2, and chemotherapy. The PDOX models were randomized into the following groups 14 days after implantation: G1, control without treatment; G2, CDDP (6 mg/kg, intraperitoneal (i.p.) injection, weekly, for 2 weeks); G3, rMETase (100 unit/mouse, i.p., daily, for 2 weeks). G4, S. typhimurium A1-R (5 × 107 CFU/100 μl, i.v., weekly, for 2 weeks); G5, S. typhimurium A1-R (5 × 107 CFU/100 μl, i.v., weekly, for 2 weeks) combined with rMETase (100 unit/mouse, i.p., daily, for 2 weeks); G6, S. typhimurium A1-R (5 × 107 CFU/100 μl, i.v., weekly, for 2 weeks) combined with rMETase (100 unit/mouse, i.p., daily, for 2 weeks) and CDDP (6 mg/kg, i.p. injection, weekly, for 2 weeks). On day 14 after initiation, all treatments except CDDP alone, significantly inhibited tumor growth compared to untreated control: (CDDP: p = 0.586; rMETase: p = 0.002; S. typhimurium A1-R: p = 0.002; S. typhimurium A1-R combined with rMETase: p = 0.0004; rMETase combined with both S. typhimurium A1-R and CDDP: p = 0.0001). The decoy, trap and kill combination of S. typhimurium A1-R, rMETase and CDDP was the most effective of all therapies and was able to eradicate the metastatic osteosarcoma PDOX.
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Affiliation(s)
- Kentaro Igarashi
- a AntiCancer, Inc. , San Diego , CA, USA.,b Department of Surgery , University of California , San Diego , CA, USA.,c Department of Orthopaedic Surgery , Kanazawa University , Kanazawa , Japan
| | - Kei Kawaguchi
- a AntiCancer, Inc. , San Diego , CA, USA.,b Department of Surgery , University of California , San Diego , CA, USA
| | - Tasuku Kiyuna
- a AntiCancer, Inc. , San Diego , CA, USA.,b Department of Surgery , University of California , San Diego , CA, USA
| | - Kentaro Miyake
- a AntiCancer, Inc. , San Diego , CA, USA.,b Department of Surgery , University of California , San Diego , CA, USA
| | - Masuyo Miyake
- a AntiCancer, Inc. , San Diego , CA, USA.,b Department of Surgery , University of California , San Diego , CA, USA
| | - Shukuan Li
- a AntiCancer, Inc. , San Diego , CA, USA
| | | | - Yuying Tan
- a AntiCancer, Inc. , San Diego , CA, USA
| | - Ming Zhao
- a AntiCancer, Inc. , San Diego , CA, USA
| | - Yunfeng Li
- d Dept. of Pathology , University of California , Los Angeles , CA , USA
| | - Scott D Nelson
- d Dept. of Pathology , University of California , Los Angeles , CA , USA
| | - Sarah M Dry
- d Dept. of Pathology , University of California , Los Angeles , CA , USA
| | - Arun S Singh
- e Division of Hematology-Oncology , University of California , Los Angeles , CA , USA
| | - Irmina A Elliott
- f Division of Surgical Oncology , University of California , Los Angeles , CA , USA
| | - Tara A Russell
- f Division of Surgical Oncology , University of California , Los Angeles , CA , USA
| | - Mark A Eckardt
- g Department of Surgery, Yale School of Medicine , New Haven , CT, USA
| | - Norio Yamamoto
- c Department of Orthopaedic Surgery , Kanazawa University , Kanazawa , Japan
| | - Katsuhiro Hayashi
- c Department of Orthopaedic Surgery , Kanazawa University , Kanazawa , Japan
| | - Hiroaki Kimura
- c Department of Orthopaedic Surgery , Kanazawa University , Kanazawa , Japan
| | - Shinji Miwa
- c Department of Orthopaedic Surgery , Kanazawa University , Kanazawa , Japan
| | - Hiroyuki Tsuchiya
- c Department of Orthopaedic Surgery , Kanazawa University , Kanazawa , Japan
| | - Fritz C Eilber
- f Division of Surgical Oncology , University of California , Los Angeles , CA , USA
| | - Robert M Hoffman
- a AntiCancer, Inc. , San Diego , CA, USA.,b Department of Surgery , University of California , San Diego , CA, USA
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Igarashi K, Kawaguchi K, Kiyuna T, Miyake K, Miyake M, Li Y, Nelson SD, Dry SM, Singh AS, Elliott IA, Russell TA, Eckardt MA, Yamamoto N, Hayashi K, Kimura H, Miwa S, Tsuchiya H, Eilber FC, Hoffman RM. Temozolomide combined with irinotecan regresses a cisplatinum-resistant relapsed osteosarcoma in a patient-derived orthotopic xenograft (PDOX) precision-oncology mouse model. Oncotarget 2018; 9:7774-7781. [PMID: 29487690 PMCID: PMC5814257 DOI: 10.18632/oncotarget.22892] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 11/10/2017] [Indexed: 12/13/2022] Open
Abstract
Relapsed osteosarcoma is a recalcitrant tumor. A patient's cisplatinum (CDDP)-resistant relapsed osteosarcoma lung metastasis was previously established orthotopically in the distal femur of mice to establish a patient-derived orthotopic xenograft (PDOX) model. In the present study, the PDOX models were randomized into the following groups when tumor volume reached 100 mm3: G1, control without treatment; G2, CDDP (6 mg/kg, intraperitoneal (i.p.) injection, weekly, for 2 weeks); gemcitabine (GEM) (100 mg/kg, i.p., weekly, for 2 weeks) combined with docetaxel (DOC) (20 mg/kg, i.p., once); temozolomide (TEM) (25 mg/kg, p.o., daily, for 2 weeks) combined with irinotecan (IRN) (4 mg/kg i.p., daily for 2 weeks). Tumor size and body weight were measured with calipers and a digital balance twice a week. After 2 weeks, all treatments significantly inhibited tumor growth except CDDP compared to the untreated control: CDDP: p = 0.093; GEM+DOC: p = 0.0002, TEM+IRN: p < 0.0001. TEM combined with IRN was significantly more effective than either CDDP (p = 0.0001) or GEM combined with DOC (p = 0.0003) and significantly regressed the tumor volume compared to day 0 (p = 0.003). Thus the PDOX model precisely identified the combination of TEM-IRN that could regress the CDDP-resistant relapsed metastatic osteosarcoma PDOX.
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Affiliation(s)
- Kentaro Igarashi
- AntiCancer, Inc., San Diego, California, USA
- Department of Surgery, University of California, San Diego, California, USA
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Kei Kawaguchi
- AntiCancer, Inc., San Diego, California, USA
- Department of Surgery, University of California, San Diego, California, USA
| | - Tasuku Kiyuna
- AntiCancer, Inc., San Diego, California, USA
- Department of Surgery, University of California, San Diego, California, USA
| | - Kentaro Miyake
- AntiCancer, Inc., San Diego, California, USA
- Department of Surgery, University of California, San Diego, California, USA
| | - Masuyo Miyake
- AntiCancer, Inc., San Diego, California, USA
- Department of Surgery, University of California, San Diego, California, USA
| | - Yunfeng Li
- Department of Pathology, University of California, Los Angeles, California, USA
| | - Scott D. Nelson
- Department of Pathology, University of California, Los Angeles, California, USA
| | - Sarah M. Dry
- Department of Pathology, University of California, Los Angeles, California, USA
| | - Arun S. Singh
- Division of Hematology-Oncology, University of California, Los Angeles, California, USA
| | - Irmina A. Elliott
- Division of Surgical Oncology, University of California, Los Angeles, California, USA
| | - Tara A. Russell
- Division of Surgical Oncology, University of California, Los Angeles, California, USA
| | - Mark A. Eckardt
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Fritz C. Eilber
- Division of Surgical Oncology, University of California, Los Angeles, California, USA
| | - Robert M. Hoffman
- AntiCancer, Inc., San Diego, California, USA
- Department of Surgery, University of California, San Diego, California, USA
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An Approach to Primary Tumors of the Upper Cervical Spine With Spondylectomy Using a Combined Approach: Our Experience With 19 Cases. Spine (Phila Pa 1976) 2018; 43:81-88. [PMID: 26020844 DOI: 10.1097/brs.0000000000001007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective study. OBJECTIVE To examine the link between major complications, surgical techniques, and perioperative care in the intralesional spondylectomy of the upper cervical spine. SUMMARY OF BACKGROUND DATA Spondylectomy has been demonstrated to prolong cancer-free survival in many patients with locally aggressive spinal tumors. However, the challenging nature of this surgical procedure and the potential for severe complications often limit its application in the upper cervical spine. METHODS Nineteen patients with primary upper cervical tumors were treated with spondylectomy from March 2005 to August 2009, using either the anterior-posterior or posterior-anterior approach. Anterior procedures were transmandibular, transoral, or high retropharyngeal. Anterior reconstructions were performed in plates with iliac crest strut grafts, plates with mesh cages, and Harms mesh cages alone. Occipitocervical fixation was performed with Halo-vest application for postoperative immobilization. RESULTS Vertebral artery injuries occurred unilaterally in 5 cases intraoperatively: 4 occurred in the anterior approach of anterior-posterior procedures. Fusion was achieved in 9 patients with intact internal instrumentation. Fusion with the anterior construct in a tilted position occurred in 3 patients, all of whom underwent anterior-posterior procedures with Halo-vest immobilization for less than 1 month. Nonunion occurred in 3 cases after the posterior-anterior procedure because of anterior bone graft absorption. Prolonged Halo-vest immobilization maintained postoperative stability. Failure of internal instrumentation occurred in 3 cases. Anterior construct dislocation and severe tilting occurred in 2 cases after the anterior-posterior procedure. Five patients had a local recurrence. All recurrent lesions were malignant tumors and occurred in regions where surgical exposure was inadequate with incomplete excision. CONCLUSION The order of the surgical approach is a critical determinant of complications, fusion rates, choice of surgical technique, and reconstruction methods. The postoperative use of a Halo-vest is recommended. Local recurrence is associated with tumor malignancy and inadequate excision margin. LEVEL OF EVIDENCE 4.
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Mavrogenis AF, Igoumenou VG, Megaloikonomos PD, Panagopoulos GN, Papagelopoulos PJ, Soucacos PN. Giant cell tumor of bone revisited. SICOT J 2017; 3:54. [PMID: 28905737 PMCID: PMC5598212 DOI: 10.1051/sicotj/2017041] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/17/2017] [Indexed: 01/15/2023] Open
Abstract
Giant cell tumor (GCT) of bone is a locally aggressive benign neoplasm that is associated with a large biological spectrum ranging from latent benign to highly recurrent and occasionally metastatic malignant bone tumor. It accounts for 4–10% of all bone tumors and typically affects the meta-epiphyseal region of long bones of young adults. The most common site involved is the distal femur, followed by the distal radius, sacrum, and proximal humerus. Clinical symptoms are nonspecific and may include local pain, swelling, and limited range of motion of the adjacent joint. Radiographs and contrast-enhanced magnetic resonance imaging (MRI) are the imaging modalities of choice for diagnosis. Surgical treatment with curettage is the optimal treatment for local tumor control. A favorable clinical outcome is expected when the tumor is excised to tumor-free margins, however, for periarticular lesions this is usually accompanied with a suboptimal functional outcome. Local adjuvants have been used for improved curettage, in addition to systematic agents such as denosumab, bisphosphonates, or interferon alpha. This article aims to discuss the clinicopathological features, diagnosis, and treatments for GCT of bone.
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Affiliation(s)
- Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, 41 Ventouri Street, 15562 Holargos, Athens, Greece
| | - Vasileios G Igoumenou
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, 41 Ventouri Street, 15562 Holargos, Athens, Greece
| | - Panayiotis D Megaloikonomos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, 41 Ventouri Street, 15562 Holargos, Athens, Greece
| | - Georgios N Panagopoulos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, 41 Ventouri Street, 15562 Holargos, Athens, Greece
| | - Panayiotis J Papagelopoulos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, 41 Ventouri Street, 15562 Holargos, Athens, Greece
| | - Panayotis N Soucacos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, 41 Ventouri Street, 15562 Holargos, Athens, Greece
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Cortini M, Avnet S, Baldini N. Mesenchymal stroma: Role in osteosarcoma progression. Cancer Lett 2017; 405:90-99. [PMID: 28774797 DOI: 10.1016/j.canlet.2017.07.024] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/19/2017] [Accepted: 07/23/2017] [Indexed: 12/21/2022]
Abstract
The initiation and progression of malignant tumors are supported by their microenvironment: cancer cells per se cannot explain growth and formation of the primary or metastasis, and a combination of proliferating tumor cells, cancer stem cells, immune cells mesenchymal stromal cells and/or cancer-associated fibroblasts all contribute to the tumor bulk. The interaction between these multiple players, under different microenvironmental conditions of biochemical and physical stimuli (i.e. oxygen tension, pH, matrix mechanics), regulates the production and biological activity of several soluble factors, extracellular matrix components, and extracellular vesicles that are needed for growth, maintenance, chemoresistance and metastatization of cancer. In osteosarcoma, a very aggressive cancer of young adults characterized by the extensive need for more effective therapies, this aspect has been only recently explored. In this view, we will discuss the role of stroma, with a particular focus on the mesenchymal stroma, contributing to osteosarcoma progression through inherent features for homing, neovascularization, paracrine cross-feeding, microvesicle secretion, and immune modulation, and also by responding to the changes of the microenvironment that are induced by tumor cells. The most recent advances in the molecular cues triggered by cytokines, soluble factors, and metabolites that are partially beginning to unravel the axis between stromal elements of mesenchymal origin and osteosarcoma cells, will be reviewed providing insights likely to be used for novel therapeutic approaches against sarcomas.
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Affiliation(s)
- Margherita Cortini
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Sofia Avnet
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Nicola Baldini
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
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11
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Igarashi K, Murakami T, Kawaguchi K, Kiyuna T, Miyake K, Zhang Y, Nelson SD, Dry SM, Li Y, Yanagawa J, Russell TA, Singh AS, Tsuchiya H, Elliott I, Eilber FC, Hoffman RM. A patient-derived orthotopic xenograft (PDOX) mouse model of a cisplatinum-resistant osteosarcoma lung metastasis that was sensitive to temozolomide and trabectedin: implications for precision oncology. Oncotarget 2017; 8:62111-62119. [PMID: 28977930 PMCID: PMC5617490 DOI: 10.18632/oncotarget.19095] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 05/24/2017] [Indexed: 01/08/2023] Open
Abstract
In the present study, we evaluated the efficacy of trabectedin (TRAB) and temozolomide (TEM) compared to cisplatinum (CDDP) on a patient-derived orthotopic xenogrraft (PDOX) of a lung-metastasis from an osteosarcoma of a patient who failed CDDP therapy. Osteosarcoma resected from the patient was implanted orthotopically in the distal femur of mice to establish PDOX models which were randomized into the following groups when tumor volume reached approximately 100 mm3: G1, control without treatment; G2, CDDP (6 mg/kg, intraperitoneal injection, weekly, for 2 weeks); G3, TRAB (0.15 mg/kg, intravenous injection, weekly, for 2 weeks); G4, TEM (25 mg/kg, oral, daily, for 14 days). Tumor size and body weight were measured with calipers and a digital balance, respectively, twice a week. On day 14 after initiation of treatment, TEM and TRAB, but not CDDP, significantly inhibited tumor volume compared to untreated control: control (G1): 814.5±258.8 mm3; CDDP (G2): 608.6±126.9 mm3; TRAB (G3): 286.6±133.0 mm3; TEM (G4): 182.9±69.1 mm3. CDDP vs. control, p=0.07; TRAB vs. control, p=0.0004; TEM vs. control p =0.0002; TRAB vs. CDDP, p =0.0002; TEM vs. CDDP, p =0.00003. The results of the present study show that a PDOX model of an osteosarcoma lung-metastasis that recurred after adjuvant CDDP-treatment has identified potentially, highly-effective drugs for this recalcitrant disease, while accurately maintaining the CDDP resistance of the tumor in the patient, thereby demonstrating the potential of the osteosarcoma PDOX model for precision oncology.
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Affiliation(s)
- Kentaro Igarashi
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA.,Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Takashi Murakami
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Kei Kawaguchi
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Tasuku Kiyuna
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Kentaro Miyake
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Yong Zhang
- AntiCancer, Inc., San Diego, California, USA
| | - Scott D Nelson
- Department of Pathology, University of California, Los Angeles, California, USA
| | - Sarah M Dry
- Department of Pathology, University of California, Los Angeles, California, USA
| | - Yunfeng Li
- Department of Pathology, University of California, Los Angeles, California, USA
| | - Jane Yanagawa
- Division of Surgical Oncology, University of California, Los Angeles, California, USA
| | - Tara A Russell
- Division of Surgical Oncology, University of California, Los Angeles, California, USA
| | - Arun S Singh
- Division of Hematology-Oncology, University of California, Los Angeles, California, USA
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Irmina Elliott
- Division of Surgical Oncology, University of California, Los Angeles, California, USA
| | - Fritz C Eilber
- Division of Surgical Oncology, University of California, Los Angeles, California, USA
| | - Robert M Hoffman
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
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12
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Mishra CB, Mongre RK, Kumari S, Jeong DK, Tiwari M. Novel Triazole-Piperazine Hybrid Molecules Induce Apoptosis via Activation of the Mitochondrial Pathway and Exhibit Antitumor Efficacy in Osteosarcoma Xenograft Nude Mice Model. ACS Chem Biol 2017; 12:753-768. [PMID: 28084722 DOI: 10.1021/acschembio.6b01007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Mitochondria impart a crucial role in the regulation of programmed cell death and reactive oxygen species (ROS) generation, besides serving as a primary energy source. Mitochondria appeared as an important target for the therapy of cancer due to their significant contribution to cell survival and death. Here, we report the design and synthesis of a novel series of triazole-piperazine hybrids as potent anticancer agents. MCS-5 emerged as an excellent anticancer agent which showed better anticancer activity than the standard drug doxorubicin in in vitro and in vivo studies. MCS-5 displayed an IC50 value of 1.92 μM and induced apoptosis in Cal72 (human osteosarcoma cell line) cells by targeting the mitochondrial pathway. This compound arrested the G2/M phase of the cell cycle and induced ROS production and mitochondrial potential collapse in Cal72 cells. MCS-5 displayed excellent anticancer activity in the Cal72 xenograft nude mice model, where it significantly reduced tumor progression, leading to enhanced life span in treated animals compared to control and doxorubicin treated animals without exerting noticeable toxicity. In addition, a 2DG optical probe guided study clearly evoked that MCS-5 remarkably reduced tumor metastasis in the Cal72 xenograft nude mice model. These results indicate that MCS-5 appeared as a novel chemical entity which is endowed with excellent in vitro as well as in vivo anticancer activity and may contribute significantly to the management of cancer in the future.
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Affiliation(s)
- Chandra Bhushan Mishra
- Bio-organic
Chemistry Laboratory, Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi 110007, India
| | - Raj Kumar Mongre
- Laboratory
of Animal Genetic Engineering and Stem Cell Biology, Department of
Animal Biotechnology and Advance Next Generation Convergence, Faculty
of Biotechnology, Jeju National University, Jeju-Do, Republic of Korea
| | - Shikha Kumari
- Bio-organic
Chemistry Laboratory, Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi 110007, India
| | - Dong Kee Jeong
- Laboratory
of Animal Genetic Engineering and Stem Cell Biology, Department of
Animal Biotechnology and Advance Next Generation Convergence, Faculty
of Biotechnology, Jeju National University, Jeju-Do, Republic of Korea
| | - Manisha Tiwari
- Laboratory
of Animal Genetic Engineering and Stem Cell Biology, Department of
Animal Biotechnology and Advance Next Generation Convergence, Faculty
of Biotechnology, Jeju National University, Jeju-Do, Republic of Korea
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13
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Cortini M, Massa A, Avnet S, Bonuccelli G, Baldini N. Tumor-Activated Mesenchymal Stromal Cells Promote Osteosarcoma Stemness and Migratory Potential via IL-6 Secretion. PLoS One 2016; 11:e0166500. [PMID: 27851822 PMCID: PMC5112800 DOI: 10.1371/journal.pone.0166500] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 10/28/2016] [Indexed: 12/20/2022] Open
Abstract
Osteosarcoma (OS) is an aggressive bone malignancy with a high relapse rate despite combined treatment with surgery and multiagent chemotherapy. As for other cancers, OS-associated microenvironment may contribute to tumor initiation, growth, and metastasis. We consider mesenchymal stromal cells (MSC) as a relevant cellular component of OS microenvironment, and have previously found that the interaction between MSC and tumor cells is bidirectional: tumor cells can modulate their peripheral environment that in turn becomes more favorable to tumor growth through metabolic reprogramming. Here, we determined the effects of MSC on OS stemness and migration, two major features associated with recurrence and chemoresistance. The presence of stromal cells enhanced the number of floating spheres enriched in cancer stem cells (CSC) of the OS cell population. Furthermore, the co-culturing with MSC stimulated the migratory capacity of OS via TGFβ1 and IL-6 secretion, and the neutralizing antibody anti-IL-6 impaired this effect. Thus, stromal cells in combination with OS spheres exploit a vicious cycle where the presence of CSC stimulates mesenchymal cytokine secretion, which in turn increases stemness, proliferation, migration, and metastatic potential of CSC, also through the increase of expression of adhesion molecules like ICAM-1. Altogether, our data corroborate the concept that a comprehensive knowledge of the interplay between tumor and stroma that also includes the stem-like fraction of tumor cells is needed to develop novel and effective anti-cancer therapies.
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Affiliation(s)
- Margherita Cortini
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli (IOR), 40136, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
| | - Annamaria Massa
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli (IOR), 40136, Bologna, Italy
| | - Sofia Avnet
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli (IOR), 40136, Bologna, Italy
| | - Gloria Bonuccelli
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli (IOR), 40136, Bologna, Italy
| | - Nicola Baldini
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli (IOR), 40136, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
- * E-mail:
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14
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He YT, Zhang QM, Kou QC, Tang B. In vitro generation of cytotoxic T lymphocyte response using dendritic cell immunotherapy in osteosarcoma. Oncol Lett 2016; 12:1101-1106. [PMID: 27446401 DOI: 10.3892/ol.2016.4714] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/19/2016] [Indexed: 11/05/2022] Open
Abstract
Immunotherapy with tumor lysate-pulsed dendritic cells (DCs) is one of the breakthrough strategies used in the treatment of cancer. However, DC-based immunotherapies for osteosarcoma are limited. In the present study, preclinical studies of a C3H osteosarcoma mouse model (produced by subcutaneous injection of LM8 murine osteosarcoma cells) validated the concept that LM8 cell lysate-pulsed bone marrow-derived DCs may evoke a more potent immune response compared with DCs that have been matured using polyinosinic:polycytidylic acid (poly I:C). A cytotoxic T lymphocyte (CTL) response was established using two groups of C3H mice (n=9) with osteosarcoma; the treatment group consisted of LM8 cell lysate-pulsed DCs and the control group consisted of DCs matured using poly I:C. Each group was immunized with doses of 1×106 cells twice per week for 3 weeks. No difference in the expression of cluster of differentiation markers was identified in the two groups. DCs pulsed with LM8 cell lysate were associated with the increased induction of CTL activity. Serum interferon-γ levels were increased in mice that received DCs pulsed with LM8 cell lysate compared with that in the poly I:C-matured DC group (P<0.041). Serum interleukin-4 was decreased in the treatment group vs. the control group (P<0.033). A mixed lymphocyte reaction assay confirmed that LM8-DC immunotherapy may evoke a significant antigen-specific immune response in a mouse model. The present study reveals promising data on efficacy of a DC-based immunotherapy in the treatment of osteosarcoma; however, further clinical studies are warranted.
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Affiliation(s)
- Ye-Teng He
- Department of Orthopedics, Shandong Province Qianfoshan Hospital, Shandong University, Jinan, Shandong 250014, P.R. China
| | - Qing-Min Zhang
- Department of Orthopedics, Tai'an City Central Hospital, Tai'an, Shandong 271000, P.R. China
| | - Quan-Chun Kou
- Department of Orthopedics, Lanling Chinese Medicine Hospital, Linyi, Shandong 277700, P.R. China
| | - Bo Tang
- Department of Orthopedics, Tai'an City Central Hospital, Tai'an, Shandong 271000, P.R. China
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15
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LONG XINHUA, ZHONG ZHENHAO, PENG AIFEN, ZHU LIANGBO, WANG HENG, ZHANG GUOMEI, LIU ZHILI. LY294002 suppresses the malignant phenotype and sensitizes osteosarcoma cells to pirarubicin chemotherapy. Mol Med Rep 2014; 10:2967-72. [DOI: 10.3892/mmr.2014.2617] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 05/19/2014] [Indexed: 11/05/2022] Open
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16
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Kawano M, Itonaga I, Iwasaki T, Tsumura H. Enhancement of antitumor immunity by combining anti-cytotoxic T lymphocyte antigen-4 antibodies and cryotreated tumor lysate-pulsed dendritic cells in murine osteosarcoma. Oncol Rep 2013; 29:1001-6. [PMID: 23291864 DOI: 10.3892/or.2013.2224] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 10/30/2012] [Indexed: 11/06/2022] Open
Abstract
Immunotherapy with tumor lysate-loaded dendritic cells (DCs) is one of the most promising strategies to induce antitumor immune responses. However, the antitumor activity of cytotoxic T cells may be restrained by their expression of the inhibitory T-cell coreceptor cytotoxic T lymphocyte antigen-4 (CTLA-4). By relieving this restraint, CTLA-4-blocking antibodies promote tumor rejection, but the full scope of their most suitable applications has yet to be fully determined. In the present study, we offer proof of a preclinical concept in a C3H mouse osteosarcoma (LM8) model that CTLA-4 blockade cooperates with cryotreated tumor lysate-pulsed DCs in a primary tumor to prevent the outgrowth of lung metastasis. To evaluate immune response activation, we established the following four groups of C3H mice (60 mice in total): i) control immunoglobulin G (IgG)-treated mice; ii) tumor lysate-pulsed DC-treated mice; iii) anti-CTLA-4 antibody-treated mice and iv) tumor lysate-pulsed DC- and anti-CTLA-4 antibody-treated mice. The mice that received the tumor lysate-pulsed DCs and anti-CTLA-4 antibody displayed reduced numbers of regulatory T lymphocytes and increased numbers of CD8+ T lymphocytes inside the metastatic tumor, inhibition of metastatic growth, a prolonged lifetime, reduced numbers of regulatory T lymphocytes in the spleen and high serum interferon-γ levels. Combining an anti-CTLA-4 antibody with tumor lysate-pulsed DCs enhanced the systemic immune response. To the best of our knowledge, these findings document for the first time an effect of the combination of tumor lysate-pulsed DCs and CTLA-4-blocking antibodies in osteosarcoma. We suggest that cryotreated tumor lysate-pulsed DCs, although insufficient on their own, may mediate the rejection of metastatic lesions and prevent recurrence of the disease when combined with CTLA-4 blockade in osteosarcoma patients in the clinical setting.
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Affiliation(s)
- Masanori Kawano
- Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita 879-5593, Japan.
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17
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Christoforou D, Golant A, Ort PJ. Arthroscopically Assisted Two-stage Cementation Technique for a Periarticular Knee Lesion. Orthopedics 2010; 33. [PMID: 20349878 DOI: 10.3928/01477447-20100129-30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Managing skeletal metastatic disease can be a challenging task for the orthopedic surgeon. In patients who have poor survival prognoses or are poor candidates for extensive reconstructive procedures, management with intralesional curettage and stabilization with bone cement with or without internal fixation to prevent development or propagation of a pathologic fracture may be the best option. The use of bone cement is preferable over the use of bone graft, as it allows for immediate postoperative weight bearing on the affected extremity.This article describes a case where the combined use of arthroscopy and a 2-stage cementation technique may allow preservation of the articular surface and optimization of short-term functional outcome after curettage of a periarticular metastatic lesion in a patient with an end-stage malignancy. We used knee arthroscopy to identify any articular penetration or intra-articular loose bodies after curettage and initial cementation of the periarticular lesion of the distal femur. Arthroscopic evaluation was carried out again after the lesion was packed with cement to identify and remove any loose intra-articular debris. The applicability of this technique is broad, and it can be used in any procedure involving cement packing in a periarticular location. Performed with caution, this technique can be a useful adjunct to surgical management of both malignant and locally aggressive benign bone lesions in periarticular locations.
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Affiliation(s)
- Dimitrios Christoforou
- Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, 301 E 17th St, 14th Floor, New York, NY 10003, USA.
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18
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Adjuvant treatment of non-malignant active and aggressive bone tumors. CURRENT ORTHOPAEDIC PRACTICE 2009. [DOI: 10.1097/bco.0b013e3181ae6abe] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Ruggieri P, Angelini A, Montalti M, Pala E, Calabrò T, Ussia G, Abati CN, Mercuri M. Tumours and tumour-like lesions of the hip in the paediatric age: a review of the Rizzoli experience. Hip Int 2009; 19 Suppl 6:S35-45. [PMID: 19306246 DOI: 10.1177/112070000901906s07] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Bone tumours and tumour-like lesions of the hip in children are rare. Signs and symptoms of these tumours are generally nonspecific. Delay of diagnosis is not uncommon. A high index of suspicion in young patients presenting with persistent pain and without history of trauma, that is unresolved with conservative therapy should prompt further investigation, including radiographs or computed tomography scan of the pelvis. In the experience of the Istituto Rizzoli, in patients less than 14 years (mean 9 years, ranged from 6 months to 14 years), 752 tumours and tumours-like lesions occurred in the pelvis or proximal femur, involving the hip. Tumour-like lesions accounted for 322 cases (simple bone cyst in 255, eosinophilic granuloma in 43, aneurismal bone cyst in 34), benign tumours for 340 cases (osteoid osteoma in 229, fibrous dysplasia in 63, exostosis in 48) and malignant tumours for 80 cases (Ewing's sarcoma in 53 and osteosarcoma in 27). The epidemiology, pathology, clinical presentation, and radiograph findings are discussed for each of these tumours.Treatment of these tumours differs from observation or minimally invasive treatment for most pseudotumoural lesions, intralesional excision or termoablation for benign bone tumours and wide resection for malignant bone tumours. In this latter group, chemotherapy is required and often administered pre- and postoperatively.
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Affiliation(s)
- P Ruggieri
- Department of Orthopedics, University of Bologna, Istituto Ortopedico Rizzoli, Via Pupilli, 1, Bologna 40136, Italy.
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20
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Lai TH, Fong YC, Fu WM, Yang RS, Tang CH. Stromal cell-derived factor-1 increase alphavbeta3 integrin expression and invasion in human chondrosarcoma cells. J Cell Physiol 2008; 218:334-42. [PMID: 18814143 DOI: 10.1002/jcp.21601] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Chondrosarcoma is a type of highly malignant tumor with a potent capacity to invade locally and cause distant metastasis. Chondrosarcoma shows a predilection for metastasis to the lungs. The stromal cell-derived factor 1 (SDF-1), constitutively secreted by human lung epithelium cells, has been shown to function in a key role for recruitment of neutrophils. Here, we found that human chondrosarcoma tissues and chondrosarcoma cell lines had significant expression of CXCR4 (SDF-1 receptor), which was higher than normal cartilage and human chondrocyte. SDF-1alpha and lung epithelium cells conditioned medium (LECM) induced the invasiveness of chondrosarcoma cells. SDF-1 siRNA inhibited LECM-induced invasion of chondrosarcoma cells and SDF-1alpha also directly induced the cell surface expression of alphavbeta3 but not alpha2beta1 and alpha5beta1 integrin. Activations of ERK and NF-kappaB pathways after SDF-1 treatment was demonstrated, and SDF-1alpha-induced expression of alphavbeta3 integrin and invasion activity was inhibited by the specific inhibitor and mutant of ERK and NF-kappaB cascades. Taken together, our results indicate that lung derived-SDF-1alpha enhances the invasiveness of chondrosarcoma cells by increasing alphavbeta3 integrin expression through the CXCR4/ERK/NF-kappaB signal transduction pathway.
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Affiliation(s)
- Tzu-Hsiu Lai
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
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21
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Osteosarcoma development and stem cell differentiation. Clin Orthop Relat Res 2008; 466:2114-30. [PMID: 18563507 PMCID: PMC2492997 DOI: 10.1007/s11999-008-0335-z] [Citation(s) in RCA: 268] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2007] [Accepted: 05/20/2008] [Indexed: 01/31/2023]
Abstract
Osteosarcoma is the most common nonhematologic malignancy of bone in children and adults. The peak incidence occurs in the second decade of life, with a smaller peak after age 50. Osteosarcoma typically arises around the growth plate of long bones. Most osteosarcoma tumors are of high grade and tend to develop pulmonary metastases. Despite clinical improvements, patients with metastatic or recurrent diseases have a poor prognosis. Here, we reviewed the current understanding of human osteosarcoma, with an emphasis on potential links between defective osteogenic differentiation and bone tumorigenesis. Existing data indicate osteosarcoma tumors display a broad range of genetic and molecular alterations, including the gains, losses, or arrangements of chromosomal regions, inactivation of tumor suppressor genes, and the deregulation of major signaling pathways. However, except for p53 and/or RB mutations, most alterations are not constantly detected in the majority of osteosarcoma tumors. With a rapid expansion of our knowledge about stem cell biology, emerging evidence suggests osteosarcoma should be regarded as a differentiation disease caused by genetic and epigenetic changes that interrupt osteoblast differentiation from mesenchymal stem cells. Understanding the molecular pathogenesis of human osteosarcoma could ultimately lead to the development of diagnostic and prognostic markers, as well as targeted therapeutics for osteosarcoma patients.
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22
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Marulanda GA, Henderson ER, Johnson DA, Letson GD, Cheong D. Orthopedic Surgery Options for the Treatment of Primary Osteosarcoma. Cancer Control 2008; 15:13-20. [DOI: 10.1177/107327480801500103] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Osteosarcoma is the most common malignant primary neoplasm of bone. Orthopedic procedures are essential components in the multidisciplinary treatment of osteosarcoma. Limb-salvaging procedures offer adequate disease control comparable to the results obtained by amputations. This review discusses the advantages and disadvantages of the various types of amputations and the limb-salvaging techniques for the treatment of osteosarcoma. Methods The authors analyzed the characteristics of limb-salvaging procedures and amputations for osteosarcoma. Qualitative and quantitative studies published in the English language that are listed in the National Library of Medicine were used as the basis for this review. In addition, a review of an expandable prosthesis is included. Results Limb-salvaging techniques have acceptable rates of disease control. However, amputation remains a valid procedure in selected cases of osteosarcoma in most parts of the world. Orthopedic oncology surgeons have various materials, procedures, and techniques available to achieve disease control and improve function in patients with osteosarcoma. Conclusions The surgical management of patients with osteosarcoma is challenging. No difference in survival has been shown between amputations and adequately performed limb-salvaging procedures. Optimal tumor resection and a functional residual limb with increased patient survival are the goals of modern orthopedic oncology.
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Affiliation(s)
- German A. Marulanda
- Department of Orthopedics and Sports Medicine at the University of South Florida, Tampa, Florida
| | - Eric R. Henderson
- Department of Orthopedics and Sports Medicine at the University of South Florida, Tampa, Florida
| | - David A. Johnson
- Sarcoma Programs at the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - G. Douglas Letson
- Department of Orthopedics and Sports Medicine at the University of South Florida, Tampa, Florida
- Sarcoma Programs at the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - David Cheong
- Sarcoma Programs at the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
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