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Xu M, Xu M, Zhang S, Li H, Qiuchi AI, Yu X, Wang XQ. Comparative efficacy of intraoperative extracorporeal irradiated and alcohol-inactivated autograft reimplantation for the management of osteosarcomas-a multicentre retrospective study. World J Surg Oncol 2021; 19:157. [PMID: 34039361 PMCID: PMC8157677 DOI: 10.1186/s12957-021-02271-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/19/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Biologic bone reconstruction in limb salvage surgery for the treatment of malignant bone tumours has always been controversial. The various inactivation methods, their convenience and stability, the curative effects elicited and associated costs all need to be considered. This study aimed to compare the clinical efficacy of intraoperative extracorporeal irradiated reimplantation with alcohol-inactivated autograft reimplantation for limb salvage surgery in patients with osteosarcoma. METHODS We retrospectively analysed 28 patients with osteosarcoma, 14 patients treated with intraoperative cobalt 60 irradiation and reimplantation (group A), and 14 patients treated by alcohol-inactivated autograft reimplantation (group B). The postoperative complications and clinical efficacy of each treatment method were compared by statistical analysis. RESULTS The local recurrence rate was 14.3% in each group. Complete bony union was achieved in 64.3% of patients in group A and 71.4% of patients in group B. The overall 5-year survival rate was 71.4% in group A and 78.6% in group B. The mean Musculoskeletal Tumor Society (MSTS) score was 25.33 ± 4.72 (range 15-30) in group A and 24.00 ± 5.85 (range 15-30) in group B, and the mean International Society of Limb Salvage (ISOLS) score was 25.79 ± 5.13 (range 20-36) in group A and 26.14 ± 5.33 (range 20-30) in group B. P < 0.05 was considered to indicate a significant difference. The results showed that the long-term clinical efficacy did not differ significantly between the two methods. CONCLUSIONS In limb salvage surgery for osteosarcoma, intraoperative extracorporeal irradiation and alcohol-inactivated autograft reimplantation yielded equivalent outcomes. The alcohol-inactivated method may be a much more convenient and inexpensive way to reconstruct bone defects. Additional studies as well as more case studies are needed to fully evaluate the clinical efficacy and safety of this treatment method.
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Affiliation(s)
- Meitao Xu
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Ming Xu
- Department of Orthopaedics, The 960th Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Jinan, China
| | - Shuai Zhang
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Hanqing Li
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - A I Qiuchi
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xiuchun Yu
- Department of Orthopaedics, The 960th Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Jinan, China.
| | - Xu Quan Wang
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China. .,Department of Orthopaedics, Gui Qian International General Hospital, Guiyang, China.
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Zacharia B, Pai PK, Paul M. Clinical and Radiological Profile of Ten Interesting Though Rare Presentations of Giant Cell Tumor of Bone. Indian J Surg Oncol 2020; 11:527-537. [PMID: 33013139 DOI: 10.1007/s13193-020-01134-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 06/08/2020] [Indexed: 11/26/2022] Open
Abstract
Giant cell tumor (GCT) is a benign but locally aggressive lesion of the bone. They are common in skeletally matured individuals with female preponderance. Unusual presentations can occur rarely. This study aims to find out the clinical and radiological profile of ten rare presentations of GCT. We have conducted a retrospective analysis of medical records of ten interesting presentations of giant cell tumor of bone. There was a patient with soft-tissue recurrence after excision. In five cases, the GCT occurred at rare sites and a case to discuss the radiological dilemma in the diagnosis. One case of pathological fracture, another case of seeding of tumor cells in the graft donor site, and a case of pulmonary metastasis were included. There were seven females, two males, and a boy. Out of ten patients, all except two cases were primarily treated at our institution. Clinical profiles of soft-tissue recurrence, rare sites of occurrence, diagnostic dilemma, pathological fracture, seeding at donor site, and metastasis were analyzed and presented. GCT, even though it is a benign lesion, can have a variety of clinical presentations and complications.
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Affiliation(s)
- Balaji Zacharia
- Department of Orthopedics, Government Medical College, Kozhikkode, Kerala PIN-673008 India
| | - Puneeth Katapadi Pai
- Department of Orthopedics, Government Medical College, Kozhikkode, Kerala PIN-673008 India
| | - Manu Paul
- Department of Surgical Oncology, Regional Cancer Centre, Trivandrum, Kerala India
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Wang PH, Wu CL, Chen CM, Wang JY, Wu PK, Chen WM. Adjuvant therapy by high-speed burr may cause intraoperative bone tumor seeding: an animal study. BMC Musculoskelet Disord 2020; 21:507. [PMID: 32736546 PMCID: PMC7395403 DOI: 10.1186/s12891-020-03544-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/28/2020] [Indexed: 12/28/2022] Open
Abstract
Background Bone tumors are often treated with intralesional curettage. High-speed burring, an adjuvant therapy, was performed to maximize the tumor cell killing; however, tumor recurrence might still occur, which may be caused by residual tumor or local tumor spread during surgery. Methods A porcine cadaver (femur) was utilized to determine whether the use of a high-speed burr causes bone cement spray. To mimic residual tumor after curettage, luminescent cement was smeared on two locations of the bone cavity, the wall and the bottom. The cavity in the femoral bone was then placed in the middle of a sheet of drawing paper featuring 10 cm, 20 cm, and 30 cm concentric circles. The luminescent cement was then burred totally with a high-speed burr. Results The intensity of the area in the wall in circle I was 72.6% ± 5.8%; within circle II, it was 22.1% ± 4.2%; and within circle III, it was 5.4% ± 1.5%. The intensity of the area within the bottom of the femoral bone within circle I was 66.5% ± 6.1%, within circle II was 28.1 ± 4.8%, and within circle III, it was 5.4% ± 1.4%. The amount of luminescent cement seeding decreased with distance, but there was no difference while burring at different locations of the bone cavity. Under the handpiece cover, a greater amount of cement spray was retained in circle I during burring of the cement in the bottom of the cavity and less was sprayed out in circle III. Conclusions High-speed burring may cause explosive bone cement spray, which could extend to 20 cm. The intensities of spray did not decrease, even when the handpiece cover was used. The wide range of bone cement spray caused by high-speed burr was inspected in this pilot study, which may lead to tumor seeding. Level of evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Pai-Han Wang
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, 201 Shi-Pai Road, Beitou District, Taipei, 11217, Taiwan.,Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Lun Wu
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, 201 Shi-Pai Road, Beitou District, Taipei, 11217, Taiwan
| | - Chao-Ming Chen
- Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, 201 Shi-Pai Road, Beitou District, Taipei, 11217, Taiwan.,Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jir-You Wang
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, 201 Shi-Pai Road, Beitou District, Taipei, 11217, Taiwan.,Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Po-Kuei Wu
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan. .,Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, 201 Shi-Pai Road, Beitou District, Taipei, 11217, Taiwan. .,Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Wei-Ming Chen
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, 201 Shi-Pai Road, Beitou District, Taipei, 11217, Taiwan.,Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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O'Connor SM, Wobker SE, Cardona DM, Eward W, Esther RJ, Dodd LG. Iatrogenic lesions of soft tissue and bone. Semin Diagn Pathol 2017; 35:208-217. [PMID: 29110897 DOI: 10.1053/j.semdp.2017.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S M O'Connor
- Department of Pathology and Laboratory Medicine, University of North Carolina Chapel Hill, United States
| | - S E Wobker
- Department of Pathology and Laboratory Medicine, University of North Carolina Chapel Hill, United States
| | - D M Cardona
- Department of Pathology, Duke University, Durham, NC, United States
| | - W Eward
- Division of Oncology, Department of Orthopaedic Surgery, Duke University, Durham, NC, United States
| | - R J Esther
- Department of Orthopaedic Surgery, University of North Carolina Chapel Hill, United States
| | - L G Dodd
- Department of Pathology and Laboratory Medicine, University of North Carolina Chapel Hill, United States.
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