Pathologic fracture does not influence prognosis in stage IIB osteosarcoma: a case–control study

详细信息    查看全文

• 作者：Dongqing Zuo (1)
  Longpo Zheng (1)
  Wei Sun (1)
  Yingqi Hua (1)
  Zhengdong Cai (1)
  
• 关键词：Amputation ; Disease ; free Survival ; Limb Salvage ; Osteosarcoma ; Pathologic Fracture
• 刊名：World Journal of Surgical Oncology
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：11
• 期：1
• 全文大小：385KB
• 参考文献：1. Jaffe N, Spears R, Eftekhari F, Robertson R, Cangir A, Takaue Y, Carrasco H, Wallace S, Ayala A, Raymond K, Wang YM: Pathologic fracture in osteosarcoma. / Impact of chemotherapy on primary tumor and survival. Cancer 1987, 59:701-09.
  2. Phoenix KA, Skrable KW, Chabot GE, French CS, Jo M, Falo GA: Determining the specific alpha activity of thick sources using a large-area zinc sulfide detector. / Health Phys 1993, 64:64-9. CrossRef
  3. Vermesan D, Vermesan H, Dragulescu SI, Bera I, Di Giovanni A, Sabatini R, Santacroce L, Bottalico L, Flace P, Cagiano R: Secondary pathologic fractures in osteosarcoma: prognosis and evolution. / Eur Rev Med Pharmacol Sci 2009, 13:71-6.
  4. Richter E: A stress fracture following osteosarcoma in a child–differential diagnosis. / Aktuelle Radiol 1993, 3:112-14.
  5. Scully SP, Ghert MA, Zurakowski D, Thompson RC, Gebhardt MC: Pathologic fracture in osteosarcoma : prognostic importance and treatment implications. / J Bone Joint Surg Am 2002, 84-A:49-7.
  6. Finn HA, Simon MA: Staging systems for musculoskeletal neoplasms. / Orthopedics 1989, 12:1365-371.
  7. Krugluger J, Eyb R: Bone reaction to uncemented threaded polyethylene acetabular components. / Int Orthop 1993, 17:259-65. CrossRef
  8. Simon MA: Limb salvage for osteosarcoma. / J Bone Joint Surg Am 1988, 70:307-10.
  9. Chandrasekar CR, Grimer RJ, Carter SR, Tillman RM, Abudu A, Jeys LM, Cheung WG, Sharma R: Pathological fracture of the proximal femur in osteosarcoma: need for early radical surgery? / ISRN Oncol 2012, 2012:512389.
  10. Kim MS, Lee SY, Lee TR, Cho WH, Song WS, Cho SH, Lee JA, Yoo JY, Jung ST, Jeon DG: Prognostic effect of pathologic fracture in localized osteosarcoma: a cohort/case controlled study at a single institute. / J Surg Oncol 2009, 100:233-39. CrossRef
  11. Xie L, Guo W, Li Y, Ji T, Sun X: Pathologic fracture does not influence local recurrence and survival in high-grade extremity osteosarcoma with adequate surgical margins. / J Surg Oncol 2012, 106:820-25. CrossRef
  12. Ferguson PC, McLaughlin CE, Griffin AM, Bell RS, Deheshi BM, Wunder JS: Clinical and functional outcomes of patients with a pathologic fracture in high-grade osteosarcoma. / J Surg Oncol 2010, 102:120-24. CrossRef
  13. Abudu A, Carter SR, Grimer RJ: The outcome and functional results of diaphyseal endoprostheses after tumour excision. / J Bone Joint Surg Br 1996, 78:652-57.
  14. Bacci G, Ferrari S, Longhi A, Donati D, Manfrini M, Giacomini S, Briccoli A, Forni C, Galletti S: Nonmetastatic osteosarcoma of the extremity with pathologic fracture at presentation: local and systemic control by amputation or limb salvage after preoperative chemotherapy. / Acta Orthop Scand 2003, 74:449-54. CrossRef
  15. Bramer JA, Abudu AA, Grimer RJ, Carter SR, Tillman RM: Do pathological fractures influence survival and local recurrence rate in bony sarcomas? / Eur J Cancer 2007, 43:1944-951. CrossRef
  16. Ebeid W, Amin S, Abdelmegid A: Limb salvage management of pathologic fractures of primary malignant bone tumors. / Cancer Control 2005, 12:57-1.
  17. Natarajan MV, Govardhan RH, Williams S: Raja Gopal TS: Limb salvage surgery for pathological fractures in osteosarcoma . / Int Orthop 2000, 24:170-72. CrossRef
  18. Niu XH, Ding Y: The surgical treatment and outcome of nonmetastatic osteosarcoma of the extremity with pathologic fractures. / Zhonghua Wai Ke Za Zhi 2008, 46:1730-733.
  19. Scully SP, Temple HT, O'Keefe RJ, Mankin HJ, Gebhardt M: The surgical treatment of patients with osteosarcoma who sustain a pathologic fracture. / Clin Orthop Relat Res 1996, 324:227-32. CrossRef
  20. Mason G, Aung L, Gall S, Meyers P, Sklar C, Butler R, Healey J, Gorlick R: Quality of life following amputation or limb salvage in patients with lower extremity sarcoma. / J Clin Oncol 2007, 25:19530.
  21. Grimer RJ, Taminiau AM, Cannon SR: Surgical outcomes in osteosarcoma. / J Bone Joint Surg Br 2002, 84:395-00. CrossRef
  22. Ruggieri P, Mavrogenis AF, Casadei R, Errani C, Angelini A, Calabro T, Pala E, Mercuri M: Protocol of surgical treatment of long bone pathological fractures. / Injury 2010, 41:1161-167. CrossRef
  23. Bacci G, Avella M, Picci P, Dallari D, Malaguti C, Biagini R, Ruggieri P, Balladelli A, Ferrari S, Caldora P: Primary chemotherapy and delayed surgery for malignant fibrous histiocytoma of bone in the extremity. / Tumori 1990, 76:537-42.
  24. Malawer M, Wittig J: The Tikhoff–Linberg procedure and its modifications. In / Musculoskeletal Cancer Surgery. Edited by: Malawer M, Sugarbaker PH. Netherlands: Springer; 2004:519-51. CrossRef
  25. Enneking WF, Spanier SS, Goodman MA: A system for the surgical staging of musculoskeletal sarcoma. / Clin Orthop Relat Res 1980, 153:106-20.
  26. Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ: A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. / Clin Orthop Relat Res 1993, 286:241-46.
  27. Shehadeh A, Noveau J, Malawer M, Henshaw R: Late complications and survival of endoprosthetic reconstruction after resection of bone tumors. / Clin Orthop Relat Res 2010, 468:2885-895. CrossRef
  
• 作者单位：Dongqing Zuo (1)
  Longpo Zheng (1)
  Wei Sun (1)
  Yingqi Hua (1)
  Zhengdong Cai (1)
  
  1. Musculoskeletal Oncology Center, Shanghai 10th People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, China
  

文摘

Objective This study tested the implication of pathologic fractures on the prognosis in stage IIb osteosarcoma. Methods A single center retrospective evaluation of clinical management and oncologic outcome was conducted with 15 pathological fracture patients (M:F = 10:5; age: mean 23.2, range 12-2) and 50 non-fracture patients between April 2002 and December 2010. These stage IIB osteosarcoma patients were matched for age, tumor site (femur, tibia, and humerus), and osteosarcoma subtype (i.e., control patients with osteosarcoma in the same sites as the fracture patients). All osteosarcoma patients with pathological fractures underwent brace or cast immobilization, adjuvant chemotherapy, and limb salvage surgery or amputation. Musculoskeletal Tumor Society (MSTS) functional scores were assessed. The mean follow-up time was 34.7 months (range, 8-7 months). Results Following limb salvage surgery, no statistical differences were observed in major complications (fracture = 20.0%, control = 12.0%, P = 0.43) or local recurrence complications (fracture = 26.7%, control = 14.0%, P = 0.25). Overall 3-year survival rates of the fracture and control groups (66.7% and 75.3%, respectively) were not statistically different (P = 0.5190). Three-year disease-free survival rates of the fracture and control groups were 53.3% and 66.5%, respectively (P = 0.25). Conclusions Pathologic fracture was not a prognostic indicator of recurrence or overall survival in localized osteosarcoma patients. Limb salvage can be achieved by and maintaining adequate surgical margins and applying adjuvant chemotherapy.