Management of primary malignant bone and soft tissue tumors of foot and ankle: Is it worth salvaging?

Özger, Harzem; Alpan, Buğra; Aycan, Osman Emre; Valiyev, Natig; Kır, Mustafa; Ağaoğlu, Fulya Yaman

doi:10.1002/jso.24817

Cited by 12 publications

(10 citation statements)

References 24 publications

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“…Previous reports in the literature are lacking meaningful prognostic information due to limited small sample sizes of malignant bone tumors. 1,2,9,12,14,[17][18][19][20]31 Univariate analysis in the current study showed older age, poor or undifferentiated grade, distant stage, size ≥8 cm, histology other than chondrosarcoma, surgical treatment other than local excision, and an earlier decade of diagnosis were found to be associated with poor outcomes. Of these, younger age group and localized stage, were found to be independent predictors of improved outcomes.…”

Section: Resultsmentioning

confidence: 50%

“…To date, epidemiological and clinical reports describing foot neoplasms have emanated from single‐centers with limited number of patients 8,9 . Some studies have lumped benign and malignant tumors together while others have limited their analysis to a particular histopathological subtype 1,3,4,10–21 . Information regarding patient characteristics and prognostic factors is limited due to small patient sample sizes, heterogenous data, and single‐center studies that are susceptible to selection bias.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Some studies have lumped benign and malignant tumors together while others have limited their analysis to a particular histopathological subtype. 1,3,4,[10][11][12][13][14][15][16][17][18][19][20][21] Information regarding patient characteristics and prognostic factors is limited due to small patient sample sizes, heterogenous data, and single-center studies that are susceptible to selection bias.…”

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confidence: 99%

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Malignant neoplasms originating from the bones of the foot: Predilection of hematological malignancies and sex‐related and ethnic disparities in amputation

Jawad

Farhan

Haffner

et al. 2021

Journal of Surgical Oncology

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Purpose: Neoplasms originating from the "small bones of the lower limb and the overlapping joints" are rare but portend a serious prognosis. Current study utilizes a population-based registry in the United States to characterize the malignancies of the foot. Methods: National Cancer Institute's Surveillance, Epidemiology and End Result database from 1975 to 2017 was queried to report incidence and survival data in 514 patients in the Uited States. Kaplan-Meier and Cox Regression were used to determine the prognostic factors affecting survival. Chi square test was used to assess the correlation.Results: Hematological malignancies constituted 14.8% of the entire cohort. Incidence of the foot neoplasms was 0.024 per 100 000 persons in 2017 and has not significantly changed since 1975 (p > 0.05). Disease-specific-5-year survival for the entire cohort was 73%. On multivariate analysis younger age groups, "localized" stage and extent of surgical resection were predictors of improved outcomes. A significant correlation was found between amputation with male sex and Hispanic ethnicity. Conclusions:The current study analyzes data from population-based registry reporting incidence and survival data for patients with neoplasms of the foot. Independent prognostic factors include age, stage and extent of surgical resection.

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Section: Resultsmentioning

confidence: 50%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Malignant neoplasms originating from the bones of the foot: Predilection of hematological malignancies and sex‐related and ethnic disparities in amputation

Jawad

Farhan

Haffner

et al. 2021

Journal of Surgical Oncology

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“…29 Many very distal extremity sarcoma series treated with limb sparing approaches report excellent MSTS scores. 14,[30][31][32][33] TESS measures physical disability and performance in activities of daily living, and is completed by the patient. 15 Though not specifically developed for extremity sarcomas, the disabilities of the arm, shoulder, and hand (DASH) questionnaire has also been utilized to evaluate patient-reported outcomes in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…The instrument, however, is completed by a physician 29 . Many very distal extremity sarcoma series treated with limb sparing approaches report excellent MSTS scores 14,30–33 . TESS measures physical disability and performance in activities of daily living, and is completed by the patient 15 .…”

Section: Discussionmentioning

confidence: 99%

Patient‐reported functional outcomes in a cohort of hand and foot sarcoma survivors treated with limb sparing surgery and radiation therapy

Ahmed

Kaggal

Harmsen

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: Describe patient-reported functional outcomes for hand and foot sarcoma survivors treated with limb-sparing surgery and radiation therapy (LSS + RT). Methods: Fifty-four patients with hand/wrist and foot/ankle sarcomas treated with LSS + RT from 1991 to 2015 were identified. Survivors ≥18 years old without subsequent amputation completed self-assessed functional surveys: Toronto upper extremity salvage score (TESS-UE) and Michigan hand outcomes (MHQ) surveys for hand; TESS lower extremity (TESS-LE) and Foot and Ankle Outcomes (FAOS) surveys for foot. Scoring scales: 0-100, MHQ and TESS;-26 to 56 and 25-59, FAOS core and shoe comfort, respectively. Higher scores denote superior function. Results: Five-year local tumor control was 88%. Fourteen of 24 hand (58%) and 14/18 foot (78%) survivors completed surveys. Mean TESS-UE and MHQ scores were 89.4 and 72.8, respectively. Mean TESS-LE, core FAOS, and shoe comfort scores were 92.4, 46.19, and 53.1, respectively. No factors correlated with outcomes. TESS-UE and MHQ scores strongly correlated (r = .87). TESS-LE and FAOS scores were associated with a poor correlation (r = .02 and r = .69). Conclusions: The largest patient-reported functional outcomes analysis for hand and foot sarcoma survivors treated with LSS + RT demonstrates excellent local tumor control and acceptable functional outcomes. Further exploration of optimal functional assessment tools is needed given the potential scope differences.

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Ortho‐oncoplastic surgery in foot and ankle: A narrative overview on reconstruction of soft‐tissue defects after oncologic resections

Angelini,

Tiengo,

Cerchiaro

et al. 2024

Microsurgery

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IntroductionMalignant tumors of the foot are rare, and treatment strategies are challenging considering the complex anatomy of this area. In recent years, dramatic advances in technology and collaborations between different specialties (such as orthopedic, oncology, radiology, plastic, and vascular surgery) significantly changed the approach to complex malignant tumors without resorting to limb removal. The combination of the strengths of both orthopedic surgery and plastic surgery constitutes the modern definition of “orthoplasty.” The aim of this review article is to provide treatment strategies that are available for reconstruction of foot and ankle in limb‐salvage surgery after tumor resection, with a specific focus on microsurgical techniques in plastic surgery.MethodsWe conducted a comprehensive search for relevant papers across PubMed, Scopus, Embase, and Web of Science. We included patient‐based studies reporting on procedures for soft‐tissue reconstruction with small and large soft tissue defects. Indications, pros and cons, and technique tips are discussed for each type of reconstructive technique.ResultsThe search was done using literature of the past 30 years (from 1990 to date), resulting in about 725 articles describing over 2000 cases. Cutaneous flaps included lateral supramalleolar flap, medial plantar flap, reverse sural neurocutaneous island flap, medial leg flap, and lateral leg flap. Free flaps included anterolateral thigh flap, radial forearm flap, latissimus dorsi flap, gracilis muscle flap, lateral arm flap, and rectus abdominis flap.ConclusionsThe orthoplastic approach in musculoskeletal oncology is a collaborative model of orthopedic and plastic surgeons working together, resulting in a higher rate of successful limb salvage in patients at risk for amputation. Protocols, biologic substitutes, and surgical techniques are largely improved in the last decades increasing the possibility of functional reconstruction. Microsurgical strategies represent the new frontiers in these demanding reconstructions.

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Management of primary malignant bone and soft tissue tumors of foot and ankle: Is it worth salvaging?

Abstract: LSS performed in specialized centers is an effective treatment method for malignant tumors of the foot and ankle.

Cited by 12 publications

References 24 publications

Malignant neoplasms originating from the bones of the foot: Predilection of hematological malignancies and sex‐related and ethnic disparities in amputation

Malignant neoplasms originating from the bones of the foot: Predilection of hematological malignancies and sex‐related and ethnic disparities in amputation

Patient‐reported functional outcomes in a cohort of hand and foot sarcoma survivors treated with limb sparing surgery and radiation therapy

Ortho‐oncoplastic surgery in foot and ankle: A narrative overview on reconstruction of soft‐tissue defects after oncologic resections

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