Limb salvage surgery for osteosarcoma

Tiwari, Afy; Jain, Sandeep; Mehta, Sandeep; Kumar, Rajesh; Kapoor, Gauri; Kumar, Kapil

doi:10.4103/0019-5413.132511

Cited by 11 publications

(7 citation statements)

References 21 publications

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“…The oncological and functional outcomes of limb salvage surgery (LSS) combined with chemotherapy are the better option for osteosarcoma patients. Our data have shown a significant improvement in disease-free survival of patients who underwent LSS than amputation, supported by (Tiwari, 2014). In the present study, a significant number of patients with osteosarcoma have a positive expression for RANKL.…”

Section: Discussionsupporting

confidence: 84%

Evaluation of the Receptor Activator of Nuclear Factor Kappa B Ligand (RANKL) Expression in Osteosarcoma and Its Association with the Clinicopathological Data

Chua

Sharif

Ismail

et al. 2021

Asian Pac J Cancer Prev

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Background:The receptor activator of nuclear factor kappa B ligand (RANKL) is one of the key regulators of bone remodelling in bone oncology, including osteosarcoma. We assessed RANKL immunohistochemical expression in osteosarcoma, its association, and disease-free survival with the patients' clinicopathological characteristics. Methods: One hundred osteosarcoma cases from 2003 to 2018 in Hospital Universiti Sains Malaysia were retrieved. The tissue samples were stained for RANKL, and the association with the clinicopathological characteristics was evaluated. Staining was interpreted in a semiquantitative scoring system and classified into negative and positive expressions. Results: Eighty-two cases had a positive expression of RANKL in which 56 and 26 patients were classified as low expression and high expression, respectively. The positive expression of RANKL did not show a significant association with clinicopathological characteristics. However, Kaplan Meier survival analysis showed a significant improvement in the disease-free survival patients who underwent limb salvage surgery (LSS) than amputated patients (p-value 0.002), whereas poorer survival was observed among conventional osteosarcomas compared to non-conventional osteosarcoma (p-value 0.01). Conclusion: Limb salvage surgery had proven to improve osteosarcoma patients' survival compared to amputation, which could improve overall quality of life in osteosarcoma patients. However, our data did not show a significant association between positive RANKL immunohistochemistry with any of the clinicopathological characteristics and patients' final survival. Further studies may be acquired to understand the suitability of using RANKL immunohistochemistry as prognostication in the management of osteosarcoma patients.

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Section: Discussionsupporting

confidence: 84%

Evaluation of the Receptor Activator of Nuclear Factor Kappa B Ligand (RANKL) Expression in Osteosarcoma and Its Association with the Clinicopathological Data

Chua

Sharif

Ismail

et al. 2021

Asian Pac J Cancer Prev

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“…Data support the use of this technique with excellent results. 2 11 Only one out of the seven patients in our series had local recurrence. ECRT is, therefore, a safe procedure with low rates of local recurrence and permits early mobilization and bone growth.…”

Section: Discussionmentioning

confidence: 72%

“…Data are limited regarding outcomes of children undergoing LSS in India. 2 Amputation would be considered only when the tumor cannot be excised with a safe margin. 10 We opted for limb salvage procedures for all patients including those with advanced disease if they showed regression of metastasis during preoperative assessment.…”

Section: Discussionmentioning

confidence: 99%

“…In developing nations like India, the survival rates are still low compared to the developed nations. 2 Patients generally tend to present late, and the disease is more advanced at presentation. This along with the use of less intense chemotherapy, delayed or inadequate surgery and limited supportive care facilities contribute to the poorer outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Methotrexate Free Chemotherapy and Limb Salvage Surgery for Paediatric Osteosarcoma in India

Sukumaran

Rajeshwari

Sugath

et al. 2018

IJOO

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Background:Osteosarcoma (OS) is the most common primary malignant tumor of bone. The survival of OS patients has steadily improved from <20% in the early 20th century to around 70% with current treatment. There are very few studies in pediatric OS from India analyzing various aspects of the disease. This study focuses on the clinical profile, treatment options, and their complications and survival outcomes in pediatric osteosarcoma (OS) patients.Materials and Methods:This was a retrospective observational study which included pediatric patients <14 years of age, with newly diagnosed OS confirmed by histological diagnosis. Medical records of all patients were reviewed for clinical profile, treatment data, surgical management, and treatment complications. Patients alive at the end of treatment were followed up and overall (OAS) and disease-free survival (DFS) were analyzed.Results:Sixty-two patients were diagnosed with OS during the study of whom 55 opted for treatment. Cisplatin, adriamycin, and ifosfamide (PAI) was offered as chemotherapy and was completed as planned in the majority of patients. Limb salvage surgery was performed in most patients (87%, n = 40). The local recurrence occurred in 7 patients. The 3 years overall survival for the cohort was 54.6% ± 7.8% and DFS was 43.4% ± 7.9%, with females and those with the localized disease having a significantly better DFS.Conclusions:High dose methotrexate free chemotherapy can give good OAS in localized disease and LSS is feasible in most of the pediatric OS patients. However the modest DFS even for localized disease with PAI chemotherapy and extremely poor outcomes in the metastatic OS, demand further research and innovations in systemic therapy to improve outcomes.

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“…Multi-agent chemotherapy combined with limb salvage surgery approach has been adopted for the amputation [6]. DDP is the drug mainly used for intra-arterial infusion chemotherapy, ADM is used for intravenous chemotherapy, and the combination of DDP and ADM is used for the amputation of chemotherapy.…”

Section: Methodsmentioning

confidence: 99%

Study on the efficacy of neoadjuvant chemotherapy on limb salvage surgery for osteosarcoma

Zhao¹

2018

biomedicalresearch

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In this study, 32 osteosarcoma patients admitted in the department of orthopedics from 2008 to 2016 were selected as subjects. Percutaneous intra-arterial chemotherapy was performed on 17 patients on the day before admission, and then the general chemotherapy was carried out on next day. After limb salvage surgery, the previous chemotherapy was repeated for 4 times. Before limb salvage surgery, the remaining 15 patients were treated with intravenous systemic chemotherapy. Fourteen days later, amputation was performed. Both the treatment strategies were compared and it was concluded that patients can adapt better to the method of limb salvage treatment after arterial and venous chemotherapy, thus the application of which is more promising.

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Limb salvage surgery for osteosarcoma

Cited by 11 publications

References 21 publications

Evaluation of the Receptor Activator of Nuclear Factor Kappa B Ligand (RANKL) Expression in Osteosarcoma and Its Association with the Clinicopathological Data

Evaluation of the Receptor Activator of Nuclear Factor Kappa B Ligand (RANKL) Expression in Osteosarcoma and Its Association with the Clinicopathological Data

Methotrexate Free Chemotherapy and Limb Salvage Surgery for Paediatric Osteosarcoma in India

Study on the efficacy of neoadjuvant chemotherapy on limb salvage surgery for osteosarcoma

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