Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 244 articles

Articles

Reliability and Validity of the Musculoskeletal Tumor Society Scoring System for the Upper Extremity in Japanese Patients

Kosuke Uehara MD, Koichi Ogura MD, Toru Akiyama MD, Yusuke Shinoda MD, Shintaro Iwata MD, Eisuke Kobayashi MD, Yoshikazu Tanzawa MD, Tsukasa Yonemoto MD, Hirotaka Kawano MD, Akira Kawai MD

The Musculoskeletal Tumor Society (MSTS) scoring system developed in 1993 is a widely used disease-specific evaluation tool for assessment of physical function in patients with musculoskeletal tumors; however, only a few studies have confirmed its reliability and validity.

Can A Multivariate Model for Survival Estimation in Skeletal Metastases (PATHFx) Be Externally Validated Using Japanese Patients?

Koichi Ogura MD, PhD, Tabu Gokita MD, PhD, Yusuke Shinoda MD, PhD, Hirotaka Kawano MD, PhD, Tatsuya Takagi MD, PhD, Keisuke Ae MD, PhD, Akira Kawai MD, PhD, Rikard Wedin MD, PhD, Jonathan A. Forsberg MD, PhD

Objective survival estimates are important when treating or studying outcomes in patients with skeletal metastases. One decision-support tool, PATHFx (www.pathfx.org) is designed to predict each patient’s postsurgical survival trajectory at 1, 3, 6, and 12 months in patients undergoing stabilization for skeletal metastases. PATHFx has been externally validated in various western centers, but it is unknown whether it may be useful in Asian patient populations.

Pathologically Benign Lymph Nodes Can Mimic Malignancy on Imaging in Patients With Angiomatoid Fibrous Histiocytoma

Gary A. Ulaner MD, PhD, John H. Healey MD, Edward A. Athanasian MD

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue neoplasm, and its rarity makes studying it difficult. We found that several of our patients with AFH presented with radiologically suspicious local lymph nodes that were sampled because of their imaging characteristics, but the nodes proved to be benign on pathologic evaluation. Although the frequency of this finding is unknown, it seems important for orthopaedic oncologists who care for patients with AFH to know whether suspicious-appearing associated nodes in these patients warrant aggressive management.

What are the Oncologic and Functional Outcomes After Joint Salvage Resections for Juxtaarticular Osteosarcoma About the Knee?

Jing Li MD, PhD, Zhen Wang MD, Chuanlei Ji MD, Guojing Chen MD, Dong Liu MD, Haodong Zhu MD

Joint salvage surgery for patients with juxtaarticular osteosarcoma remains challenging, especially when the tumor invades the epiphysis. Because patients are surviving longer with current chemotherapy regimens, it is advantageous to retain native joints if possible, especially in young patients. However, the results using joint-preserving tumor resections in this context have not been well characterized.

Can a Bayesian Belief Network Be Used to Estimate 1-year Survival in Patients With Bone Sarcomas?

Rajpal Nandra MRCS, Michael Parry FRCS, Jonathan Forsberg MD, PhD, Robert Grimer FRCS

Extremity sarcoma has a preponderance to present late with advanced stage at diagnosis. It is important to know why these patients die early from sarcoma and to predict those at high risk. Currently we have mid- to long-term outcome data on which to counsel patients and support treatment decisions, but in contrast to other cancer groups, very little on short-term mortality. Bayesian belief network modeling has been used to develop decision-support tools in various oncologic diagnoses, but to our knowledge, this approach has not been applied to patients with extremity sarcoma.

Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton?

Tomas Zamora MD, Julio Urrutia MD, Daniel Schweitzer MD, Pedro Pablo Amenabar MD, Eduardo Botello MD

Distinguishing a benign enchondroma from a low-grade chondrosarcoma is a common diagnostic challenge for orthopaedic oncologists. Low interrater agreement has been observed for the diagnosis of cartilaginous neoplasms among radiologists and pathologists, but, to our knowledge, no study has evaluated inter- and intraobserver agreement among orthopaedic oncologists grading these lesions using initial clinical and imaging information. Determining such agreement is important since it reflects the certainty in the diagnosis by orthopaedic oncologists. Agreement also is important as it will guide future treatment and prognosis, considering that there is no gold standard for diagnosis of these lesions.

Is Limb Salvage With Microwave-induced Hyperthermia Better Than Amputation for Osteosarcoma of the Distal Tibia?

Kang Han MD, PhD, Peiye Dang MS, Na Bian MS, Xiang Chen MD, PhD, Tongtao Yang MD, PhD, QingYu Fan MD, PhD, Yong Zhou MD, PhD, Tingbao Zhao MD, PhD, Pingshan Wang MD, PhD

Amputation has been the standard surgical treatment for distal tibia osteosarcoma owing to its unique anatomic features. Preliminary research suggested that microwave-induced hyperthermia may have a role in treating osteosarcoma in some locations of the body (such as the pelvis), but to our knowledge, no comparative study has evaluated its efficacy in a difficult-to-treat location like the distal tibia.

Use of Compressive Osseointegration Endoprostheses for Massive Bone Loss From Tumor and Failed Arthroplasty: A Viable Option in the Upper Extremity

Krista A. Goulding MD, MPH, Adam Schwartz MD, Steven J. Hattrup MD, R. Lor Randall MD, Donald Lee MD, Damian M. Rispoli MD, Daniel M. Lerman MD, Christopher Beauchamp MD

Endoprostheses using principles of compressive osseointegration have shown good survivorship in several studies involving the lower extremity; however, no series to our knowledge have documented the use of this technology in the management of massive bone loss in the upper limb.

Freezing Nitrogen Ethanol Composite May be a Viable Approach for Cryotherapy of Human Giant Cell Tumor of Bone

Po-Kuei Wu MD, Cheng-Fong Chen MD, Jir-You Wang PhD, Paul Chih-Hsueh Chen MD, Ming-Chau Chang MD, Shih-Chieh Hung MD, PhD, Wei-Ming Chen MD

Liquid nitrogen has been used as adjuvant cryotherapy for treating giant cell tumor (GCT) of bone. However, the liquid phase and ultrafreezing (−196° C) properties increase the risk of damage to the adjacent tissues and may lead to perioperative complications. A novel semisolid cryogen, freezing nitrogen ethanol composite, might mitigate these shortcomings because of less-extreme freezing. We therefore wished to evaluate freezing nitrogen ethanol composite as a coolant to determine its properties in tumor cryoablation.

Can Multistate Modeling of Local Recurrence, Distant Metastasis, and Death Improve the Prediction of Outcome in Patients With Soft Tissue Sarcomas?

Florian Posch MD, MSc, Lukas Leitner MD, PhD, Marko Bergovec MD, Angelika Bezan MD, Michael Stotz MD, Armin Gerger MD, MBA, Martin Pichler MD, MSc, Herbert Stöger MD, Bernadette Liegl-Atzwanger MD, Andreas Leithner MD, Joanna Szkandera MD

Exploration of the complex relationship between prognostic indicators such as tumor grade and size and clinical outcomes such as local recurrence and distant metastasis in patients with cancer is crucial to guide treatment decisions. However, in patients with soft tissue sarcoma, there are many gaps in our understanding of this relationship. Multistate analysis may help us in gaining a comprehensive understanding of risk factor-outcome relationships in soft tissue sarcoma, because this methodology can integrate multiple risk factors and clinical endpoints into a single statistical model. To our knowledge, no study of this kind has been performed before in patients with soft tissue sarcoma.