Functional outcome of surgical treatment of adults with extremity osteosarcoma after megaprosthetic reconstruction—single-center experience

Abstract

Background: Osteosarcoma is the most common primary malignant bone tumor in adults and is usually located in the long bones. Standard treatment consists of perioperative chemotherapy and radical surgical resection. Limbsparing surgery using a variety of reconstructive techniques remains the gold standard. Methods: In our study, we retrospectively analyzed 90 adult patients operated at our institution between 2000 and 2017 for extremity osteosarcoma that underwent limb-sparing reconstruction with the megaprosthesis. Sixty-one patients underwent resection and reconstruction of the distal femur, 9 patients-proximal femur, 7 patientsproximal tibia, 5 patients-total femoral resection and reconstruction, 5 patients-proximal humeral resection, and 3 patients-other types of resection with endoprosthetic reconstruction. The median follow-up time was 41 months, median overall survival was 86 months (3-225 months), and progression-free survival was 81 months (1-86 months). Functional assessment was made on 48 out of 56 living patients, after endoprosthetic reconstruction. The assessment was made according to MSTS functional scale. Results: In 14 cases (15%), the endoprosthesis had to be explanted, or amputation was performed for local recurrence or septic complication. Due to a mechanical failure of the implant, we had to perform a revision in 5 patients (5%). Eighteen out of 74 patients with endoprosthesis died of the disease. The median MSTS score was 84% (53-100%), and the best result of 85% was achieved in patients after distal femoral resection with endoprosthetic reconstruction. Conclusion: Careful planning of the treatment of patients with extremity osteosarcoma that is performed at the referral centers gives the possibility of long-term survival with a good and excellent functional result.

Cross-Cultural Validation of the Italian Version of the Bt-DUX: A Subjective Measure of Health-Related Quality of Life in Patients Who Underwent Surgery for Lower Extremity Malignant Bone Tumour

“…The five-year survival rate is 60% [ 1 ]. Improved survival rates, surgical techniques, and the young age of patients affected by this disease have over time attracted growing interest in the functional outcome and quality of life (QoL) after surgery [ 2 , 3 , 4 , 5 ].…”

Hyoid Bone Metastasis in Patients With Lung Adenocarcinoma: A Case Report

“…Considering that osteosarcoma and myeloma, which can cause osteolytic lesions, also require pathological diagnosis and surgical intervention, 10,11 and in many circumstances, the life quality of patients will be significantly affected if the patients do not receive surgical intervention for bone metastases of lung cancer, 12 we performed the mass resection surgery based on comprehensive assessment according to Expert Consensus on Diagnosis and Treatment of Bone Metastasis from Lung Cancer (version 2019): the patient could live for more than 3 months in good condition; the patient was able to tolerate surgical trauma and anesthesia; the patient was expected to have a better life quality after surgery than before. During the operation, we removed the tumor completely and identified the hyoid mass as a metastatic lesion of lung adenocarcinoma.…”

PENK inhibits osteosarcoma cell migration by activating the PI3K/Akt signaling pathway

“…OS is characterized by direct formation of osteoid tissue or immature bone by tumor cells [3] and accounts for approximately 60% of pediatric bone tumors [4]. Traditional treatment strategies for OS mainly include medical approaches such as multidrug chemotherapy and wide surgical excision [5]. However, the inhibitory effect of these strategies on the progression of OS is limited.…”