The article is devoted to study health-related quality of life and attitude to disease in 120 patients with bone tumor: osteosarcoma (41 persons), giant cell tumor (31 persons), chondrosarcoma (30 persons) and metastatic bone lesion (18 persons).Comparative analysis of quality of life basic parameters, attitude to disease and indices interconnections in four clinical groups of patients was made. Psychological methods were as follows: «SF-36 Health StatusSurvey», Quality of Life Questionnary-Core 30 of European Organization for Research and Treatment Cancer with module Bone Metastases 22, "The type of relation to disease". The results revealed differences in quality of life parameters, attitude to disease types and differences of correlations between the diagnostics indices in patients with different bone tumor types.
European Organization of Research and Treatment of Cancer (EORTC) Bone Metastases (BM22), developed by the Quality of Life Assessment Group, is a specialized module of the quality of life questionnaire EORTC QLQ-C30, assessing the quality of life in patients with bone tumors. The aim of the study is to develop its Russian version. The study included a sample of 139 patients with bone tumors — inpatients of N.N. Blokhin Cancer Research Center. The scale has a good convergent validity and internal consistency (0,871), factor analysis confirmed the structure of the scale and its compliance with the original model. The results revealed significant decrease in quality of life due to patients’ focus on pain and its severity. We conclude by drawing out the main directions of psychological aid to patients with bone tumors.
3D printing has opened new opportunities for the development of personalized systems for prosthetics of extensive chest wall defects after radical surgical interventions for malignant tumors. However, risk factors for an adverse outcome of such operations have not yet been identified.Clinical cases. A 65-year-old man with primary chondrosarcoma of the V rib, underwent surgical resection of three ribs, plasty with local tissues, and an individual 3D printed titanium implant was installed on the sternum and IV-VI ribs. Follow up for 26 months showed no complaints or signs of recurrence. A 52-year-old woman with radiation-induced soft tissue sarcoma of the chest wall, that developed 9 years after radiation for breast cancer, underwent resection of four ribs and pectoral muscles and a 3D printed titanium implant was installed on the sternum and II-V ribs. The operation was complicated by the marginal necrosis of the soft tissue flap and infection of the endoprosthesis, which required removal of the metal structure and reconstruction using TRAM flap. After 9 months, a local recurrence of the tumor was diagnosed. Discussion. As a factor of a positive outcome in a man should be noted a thick layer of subcutaneous fat with muscle tissue, due to which plastic surgery was performed, covering the defect without tension. An extensive resection of the pectoral muscles in a woman created a tissue deficit. Another factor of an unfavorable outcome can be considered the radio-induced nature of the sarcoma. Further research is needed to improve the strategy for selecting patients with malignant tumors of the chest wall for prosthetics.
Objective. The aim of this study is to improve the results of surgical treatment of lung metastases of soft tissue sarcomas, to analyze the factors that may affect the effectiveness of surgical treatment.Materials and methods.The study included 80 patients with metastases of bone sarcomas in the lungs, who received treatment in the period from 2000 to 2013. Among the patients there were 42 (48,5 %) men and 38 (51,5 %) women.The median age at diagnosis was 33 years (range 17 to 75). The majority of soft tissue sarcomas were represented by malignant fibrous histiocytoma (27,5 %) and synovial sarcoma (28,5 %). Almost all patients (96 %) underwent chemotherapy before surgery for lung metastases. The indication for surgery in most cases (52,5 %) was metastases in the lungs as the only manifestation of the disease. Most often, operations were performed with unilateral lung lesions (67,5 %).Results. Atypical lung resections 58 (72 %) were the most frequently performed volume of surgical intervention, pneumonectomy, bilobectomy and lobectomy were used in 17 (22 %) cases. Combined resections were performed in six patients. Postoperative complications were observed in 6 (7,5 %) patients. The radicality of the operations performed in the study group was 93 % in the R0 volume, in the R1 volume, 4 % of the operations were performed, in the R2 volume, 1 patient was operated on. The most frequent postoperative complication was pneumonia, one patient died in the early postoperative period from complications of surgery. The median follow-up in the study group was 49,2 months (from 3,5 to 239 months). The overall 5-year survival rate in the study group was 41,5 %. Five-year overall survival was more than 30 % higher in the group of patients who had less than 3 metastatic lesions at baseline. Only the following factors have a direct impact on OS indicators: the number and size of metastatic foci, radical removal of metastatic foci, the effect of previous chemotherapy, and the timing of the development of metastatic lesions. In our study, there were also no differences in OS and PFS depending on the surgical approach used.Conclusion.Surgical treatment is currently fully justified and the only really effective treatment method that can lead to longer-term survival in patients with metastases of sarcomas in the lungs, despite the fact that some metastases have a clear resistance to all types of conservative therapy, while The best treatment results are achieved in the presence of a long disease-free interval (DFI), a small number of metastases and their removal in the R0 volume.
The article is devoted to description of psychological assistance program in oncoorthopedic clinic, based on the results of studying psychological characteristics and dynamics of the main parameters of quality of life in patients with oncoorthopedic pathology.The main stages of complex psychological assistance are presented, approaches to psychodiagnostics in oncoorthopedic clinic are proposed. The main directions of psychological assistance for patients with bone tumors are identified and substantiated.
Relevance. The relevance is determined by the need to study quality of life over time in patients with spinal tumors during surgical treatment, as well as to study relationships between quality of life and psychological characteristics, including those responsible for adaptation to a disease, i.e. coping mechanisms (coping strategies and resources).Intention. To study the dynamics of the main quality-of-life parameters in patients with spinal tumors in the perioperative period, as well as to assess relationships between quality-of-life parameters and the psychological mechanisms of disease-related stress coping.Methodology. Quality-of-life parameters were studied over time (before and after surgery) in 62 patients with various spinal tumors (average age 55 years; 22 males [35.5 %]) treated at the Department of Vertebral Surgery of N.N. Blokhin National Research Center of Oncology. The relationships were studied between patients’ quality of life in the early postoperative period and their disease-related stress coping strategies and resources. The following tests were used: the 36-Item Short Form Health Survey Questionnaire (SF-36), questionnaires for studying Quality of Life in oncological disease (QLQ C-30), spine tumors (SOSG OQ), the Ways of Coping Questionnaire (WCQ), the Big Five Personality Test and the Purpose-in-Life Test.Results and Discussion. 23 of 29 studied quality-of-life parameters improved statistically significantly or tended to improve in the post- vs preoperative period, including the general index of health and quality of life, physical, emotional, social and cognitive activity, as well as symptoms of somatic distress (except an increased index of neurological dysfunction). Relationships were revealed between quality-of-life parameters and all the coping-related psychodiagnostic indices (except the “Extraversion” scale). Higher quality-of-life indices positively correlated with mature personality (internality, activity, meaningful goals, seeking social support, etc.). Less mature personality and less effective coping strategies were associated with more pronounced somatic symptoms and their impact on the quality of life in patients.Conclusion. The results of this study can help develop more targeted and individualized programs of psychological assistance and social rehabilitation for patients with spinal tumors.
Introduction. Malignant peripheral nerve sheath tumors (MPNSTs) belong to a rare heterogeneous group of aggressive neoplasms of mesenchymal origin. The relationship between the PD-L1 expression and development and prognosis of MPNSTs has not yet been determined. In addition, it is yet to explore the role of tumor microenvironment, in particular tumor-associated macrophages, in solid tumors. The aim of the study was to determine the relationship between (1) PD-L1 expression and the nuclear marker of PU.1 expression in stromal cells and (2) overall survival (OS) and recurrence-free survival (RFS) in patients with MPNSTs. Materials and methods. The retrospective study included 46 adult patients with MPNSTs who underwent surgical or combined treatment from 1998 to 2021 at the N.N. Blokhin Oncology Research Center. We analyzed clinical and morphological parameters as well as the outcomes of surgical treatment. Immunohistochemistry was used to detect the expression of PD-L1, PU.1, and Ki-67. Results. We found positive PD-L1 staining in 28% of cases. PU.1 expression was observed in all samples. We showed a statistically significant correlation between PU.1 and PD-L1 expression levels. At a median follow-up of 37 months, PD-L1 positive status was associated with a lower median OS and RFS in the group of patients with grade III tumors (p=0.0003 and p=0.004, respectively). The median OS for tumors with high and low number of PU.1+ cells was 21 and 78 months, respectively (p<0.0001). Conclusion. To the best of our knowledge, this is the first study to describe the prognostic value of the macrophage marker PU.1 in patients with MPNST. High levels of PU.1+ cells, regardless of the tumor grade, and PD-L1 expression >1% of tumor cells in the patients with poorly-differentiated MPNSTs, produced a negative effect on OS and RFS. The analyzed expression of these markers can be used in prognostic tests and developing novel therapeutic treatment options. Keywords: malignant peripheral nerve sheath tumor, PD-L1 immunohistochemistry, PU.1, surgical treatment
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.