Current concepts review. The surgical staging of musculoskeletal sarcoma.

Enneking, William F.; Spanier, Suzanne S.; Goodman, Mark A.

doi:10.2106/00004623-198062060-00028

Cited by 306 publications

(114 citation statements)

References 9 publications

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“…Delloye et al (2007), in a series of 24 patients, reported that surgical resection was wide in 19 cases, marginal in 6, and intralesional in 1. According to Enneking et al (1980), our data, obtained under ideal working conditions, are consistent with those findings.…”

Section: Resection Marginsupporting

confidence: 91%

Surgical inaccuracy of tumor resection and reconstruction within the pelvis: An experimental study

et al. 2008

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Background and purpose Osseous pelvic tumors can be resected and reconstructed using massive bone allografts. Geometric accuracy of the conventional surgical procedure has not yet been documented. The aim of this experimental study was mainly to assess accuracy of tumoral resection with a 10-mm surgical margin, and also to evaluate the geometry of the host-graft reconstruction.Methods An experimental model on plastic pelvises was designed to simulate tumor resection and reconstruction. 4 experienced surgeons were asked to resect 3 different tumors and to reconstruct pelvises. 24 resections and host-graft junctions were available for evaluation. Resection margins were measured. Several methods were created to evaluate geometric properties of the host-graft junction.Results The probability of a surgeon obtaining a 10-mm surgical margin with a 5-mm tolerance above or below, was 52% (95% CI: 37-67). Maximal gap, gap volume, and mean gap between host and graft was 3.3 (SD 1.9) mm, 2.7 (SD 2.1) cm 3 and 3.2 (SD 2.1) mm, respectively. Correlation between these 3 reconstruction measures and the degree of contact at the host-graft junction was poor.Interpretation 4 experienced surgeons did not manage to consistently respect a fixed surgical margin under ideal working conditions. The complex 3-dimensional architecture of the pelvis would mainly explain this inaccuracy. Solutions to this might be to increase the

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Section: Resection Marginsupporting

confidence: 91%

Surgical inaccuracy of tumor resection and reconstruction within the pelvis: An experimental study

et al. 2008

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“…The tumor cells were very polymorphic (anaplastic), similar to giant cells with numerous atypical mitoses or multinucleated osteoclast-like giant cells (Fig. 3A-C), similar to those observed in previous reports (29,30).…”

Section: Emmprin/cd147 Is Expressed By Human Osteosarcoma Cell Linessupporting

confidence: 89%

“…Human osteosarcoma cell lines (Saos-2, U-2OS and MG-63), human malignant melanoma cell line A375 and human osteoblast cell line Hob were harvested and after being centrifuged, cell pellets were weighed and re-suspended in an equal volume of lysis buffer. Following centrifugation, the concentrations of EMMPRIN/CD147 in the supernatants were determined by ELISA using the EMMPRIN/CD147 ELISA kit, according to the manufacturer's instructions (Biosensis, Thebarton, Australia), as reported in a previous study (28 (29,30). The patients were intravenously administered neoadjuvant chemotherapy of one cycle of 8 g/m 2 methotrexate for one day, and 120 mg/m 2 doxorubicin and 75 mg/m 2 cisplatin daily for three consecutive days for two cycles consecutively.…”

Section: Methodsmentioning

confidence: 99%

“…The patients were intravenously administered neoadjuvant chemotherapy of one cycle of 8 g/m 2 methotrexate for one day, and 120 mg/m 2 doxorubicin and 75 mg/m 2 cisplatin daily for three consecutive days for two cycles consecutively. Subsequently, these patients were subjected to surgical resection of the tumor, and their surgical margins were classified, according to the Enneking scoring system, as highly malignant intracompartmental osteogenic sarcomas (IIA), extracompartmental lesions (IIB) or osteogenic sarcomas with manifestation of metastases (III) (29,30). Following surgery, specimens were collected from individual patients and evaluated for their diagnosis and adequacy of the surgical margins.…”

Section: Methodsmentioning

confidence: 99%

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Expression and clinical significance of extracellular matrix metalloproteinase inducer, EMMPRIN/CD147, in human osteosarcoma

Lü

Kim

et al. 2012

Oncology Letters

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Abstract. Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Recent studies have shown that extracellular matrix metalloproteinase inducer (EMMPRIN/CD147) promotes adhesion, invasion and metastasis of malignant tumor cells. The aim of this study was to investigate the impact of EMMPRIN/CD147 expression on prognosis and its correlation with clinicopathological characteristics in patients with osteosarcoma. The expression of EMMPRIN/CD147 in 55 surgical specimens from patients with osteosarcoma at stage IIA or above, 15 non-tumor rib bone tissues, three human osteosarcoma cell lines (Saos-2, U-2OS and MG-63), the human osteoblast cell line HOB and the malignant melanoma cell line A375 were examined by immunohistochemistry, western blot analysis and ELISA, respectively. The potential association of the levels of EMMPRIN/CD147 expression in osteosarcoma specimens with the overall survival of patients was statistically analyzed. We found that the EMMPRIN/CD147 was expressed in 45 out of 55 osteosarcomas, with immunoreactivity primarily within the membrane and cytoplasm of tumor cells, but not in the non-tumor bone tissues. We also observed that EMMPRIN/CD147 was expressed in Saos-2, U-2OS, MG-63 and A375, but not in HOB cells. The levels of EMMPRIN/CD147 expression correlated positively with the pathological degree of osteosarcoma and negatively with the survival period of patients with osteosarcoma. The expression of EMMPRIN/CD147 is a potential factor in the development and prognosis of osteosarcoma and may be a novel therapeutic target of human osteosarcoma.

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“…The following categories were compared: patient age (patients were grouped considering the inclusion criteria of the chemotherapy protocols for soft tissue sarcomas activated in Italy: pediatric protocols enrolled patients aged aged <18 years and protocols for adults enrolled patients ages 18 to 65 years; no specific study protocols were activated in Italy for patients aged 65 years); tumor site (upper extremity: at or distal to the shoulder joint; lower extremity: in the groin or leg; and trunk: proximal to the shoulder joint and the groin); tumor size (maximum diameter 5 cm vs >5 cm); surgical margins (adequate: wide or radical; inadequate: intralesional, marginal, or contaminated margins, according to the classification of Enneking et al 20 ); histologic subtype (biphasic vs monophasic vs poorly differentiated) 3 ; status at admission (new diagnoses: previously untreated lesions; primary re-excisions: lesions excised with inadequate margins 3 months earlier; andlocal recurrences: tumor recurrence >3 months after primary tumor excision); and adjuvant treatments (radiotherapy or chemotherapy performed within 3 months after tumor excision).…”

Section: Discussionmentioning

confidence: 99%

Synovial sarcoma

Palmerini

Staals

Alberghini

et al. 2009

Cancer

142

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BACKGROUND: The optimal treatment for synovial sarcoma remains controversial. Treatment, outcome, and prognostic factors in patients treated in a single institution were examined. METHODS: Synovial sarcoma patients who underwent surgery at the Rizzoli Institute between 1976 and 2006 were identified and analyzed. RESULTS: Characteristics of the 250 patients (128 female; 122 male) included: median age, 37 years (range, 7‐83 years); 177 (71%) with tumors in the lower extremity, 40 (16%) with tumors in the upper extremity, and 33 with tumors in the trunk (13%); primary lesion size >5 cm in 121 patients (55%); and 204 (82%) patients with localized disease and 46 (18%) with metastatic disease at the time of presentation. All patients with localized disease underwent surgery. Twenty‐four percent of patients underwent amputation. Adequate surgical margins were achieved in 88% patients. In patients with localized disease, radiotherapy was administered to 103 (50%) patients, and chemotherapy to 98 (48%). With a median follow‐up of 5.5 years (range, 1‐30 years), the 5‐year overall survival rate was 10% for patients with metastatic disease and 76% for patients with localized disease (P = .0001). The 5‐year event‐free survival was 58% in patients with localized disease. Multivariate analysis indicated that size, age, histologic subtype, and the use of radiotherapy were independent factors for event‐free survival. CONCLUSIONS: In those patients with localized disease, a good rate of cure can be achieved. Age, size, histology, and use of radiotherapy influence prognosis, whereas to the authors' knowledge, the role of adjuvant chemotherapy remains unproven. Cancer 2009. © 2009 American Cancer Society.

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Current concepts review. The surgical staging of musculoskeletal sarcoma.

Cited by 306 publications

References 9 publications

Surgical inaccuracy of tumor resection and reconstruction within the pelvis: An experimental study

Surgical inaccuracy of tumor resection and reconstruction within the pelvis: An experimental study

Expression and clinical significance of extracellular matrix metalloproteinase inducer, EMMPRIN/CD147, in human osteosarcoma

Synovial sarcoma

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