Neoadjuvant chemotherapy for nonmetastatic osteosarcoma of the extremities: The recent experience at the Rizzoli Institute

Bacci, Gaetano; Picci, Piero; Ferrari, Stefano; Avella, M; Prever, B A; Ruggieri, Pietro; Casadei, Roberto; Lari, S; Monti, Carlo; Cazzola, Alberto

doi:10.1007/978-1-4615-3518-8_36

Cited by 26 publications

(19 citation statements)

References 10 publications

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“…However, 20-30% of these patients still relapse, and many of them die from disease progression (Bacci et al 1993). Clinical studies have demonstrated that response to chemotherapy is a key factor, which can dramatically inXuence the clinical outcome of high-grade osteosarcoma patients (Bacci et al 1993). Attempts to intensify standard chemotherapy regimens have resulted in a general increase of the collateral toxicity of anticancer agents, without any further signiWcant improvement in outcomes.…”

Section: Discussionmentioning

confidence: 98%

“…Because of the high rate of systemic spread, a cure is rarely achieved after surgical treatment alone. However, the introduction of high-dose, multidrug, neoadjuvant chemotherapy has led to a dramatic increase in the 5-year survival rate to approximately 70-80% (Bacci et al 1993). As a result of improved survival rates, the long-term side eVects of chemotherapy have become apparent, particularly in younger patients (Geidel et al 1991).…”

Section: Introductionmentioning

confidence: 99%

“…Response to preoperative chemotherapy is determined by histology on surgically resected specimens according to the Salzer-Kuntschik classiWcation (Salzer-Kuntschik et al 1983). However, regression grading is only available after preoperative therapy and it therefore has limited practical value in the determination of postoperative therapeutic regimes (Bacci et al 1993;Winkler et al 1988).…”

Section: Introductionmentioning

confidence: 99%

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Livin and Bcl-2 expression in high-grade osteosarcoma

Nedelcu

Kubista

Koller

et al. 2007

J Cancer Res Clin Oncol

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Livin and Bcl-2 expression in high-grade osteosarcoma

Nedelcu

Kubista

Koller

et al. 2007

J Cancer Res Clin Oncol

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“…Prior to the introduction of multi-agent chemotherapy in the 1970s, amputation enabled a long-term survival rate of about 20% in patients with high-grade osteosarcoma (45,46). However, the combination of aggressive polychemotherapy and surgery has improved the long-term survival rate to approximately 60%.…”

Section: Discussionmentioning

confidence: 99%

Nestin expression in high-grade osteosarcomas and its clinical significance

et al. 2012

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Abstract. Nestin has been detected in various malignancies and its expression correlates with advanced grade in some neoplasms. The aim of this study was to examine nestin expression in high-grade osteosarcomas and to determine its prognostic value. Using immunohistochemistry and immunofluorescence, we evaluated nestin expression in tumor tissue samples from 45 patients with high-grade osteosarcomas. In both methods, the frequency of nestin-positive tumor cells was classified into three categories (1+, 2+ and 3+ for immunohistochemistry; 1F+, 2F+ and 3F+ for immunofluorescence) and clinicopathological correlations were statistically evaluated and analyzed. Nestin-positive tumor cells were detected in all of the examined osteosarcomas using both immunohistochemistry and immunofluorescence, although the proportion of undoubtedly positive neoplastic cells varied in individual samples from a few nestin-positive tumor cells to diffuse nestin positivity. High levels of nestin expression detected by immunofluorescence (2F+ and 3F+) were associated with worse clinical outcomes (OS, P=0.031; EFS, P<0.001). However, high levels of nestin expression as measured by immunohistochemistry trended towards shorter patient survival rates but did not reach statistical significance. Despite significantly shorter survival rates observed in patients with high levels of nestin expression assessed by immunofluorescence, nestin does not seem to represent a powerful prognostic marker that would be superior to conventional methods.

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“…With the development of neoadjuvant chemotherapy and surgical techniques, the therapeutic effect on osteosarcoma has been sig- nificantly improved [13]. Currently, limb salvage surgery has been established as an alternative to amputation [14][15][16][17]. During limb salvage surgery, the combined use of chemotherapy could improve the prognosis of limb salvage.…”

Section: Discussionmentioning

confidence: 99%

Selection of Surgical Methods in the Treatment of Upper Tibia Osteosarcoma and Prognostic Analysis

et al. 2017

Oncol Res Treat

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Background: We aimed to explore the clinical effects and prognosis of different surgical methods in upper tibia osteosarcoma. Methods: Among 112 patients with proximal upper tibia osteosarcoma, 40 patients were treated with amputation, 20 patients were treated with massive osteoarticular allograft, and the remaining 52 cases were treated with tumor resection and artificial joint replacement. Results: Recurrence was observed in 2 cases (5%) in the amputation group, in 6 cases (30%) in the massive osteoarticular allograft group, and in 6 cases (12%) in the tumor resection and artificial joint replacement group (P = 0.021). The lung metastasis rates were 40% in the amputation group, 40% in the massive osteoarticular allograft group, and 38% in the tumor resection and artificial joint replacement group (P = 0.986). The survival rates at 1, 3, and 5 years were 95%, 75%, and 45%, respectively, in the amputation group, 95%, 75%, and 35%, respectively, in the massive osteoarticular allograft group, and 92.3%, 78.8%, and 53.8%, respectively, in the tumor resection and artificial joint replacement group (P > 0.05). Conclusions: The selection of the optimal surgical method for upper tibia osteosarcoma should be made according to the individual circumstances of the patient. Our study has significance for reducing the incidence of surgical complications and improving the quality of postoperative life.

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Neoadjuvant chemotherapy for nonmetastatic osteosarcoma of the extremities: The recent experience at the Rizzoli Institute

Cited by 26 publications

References 10 publications

Livin and Bcl-2 expression in high-grade osteosarcoma

Livin and Bcl-2 expression in high-grade osteosarcoma

Nestin expression in high-grade osteosarcomas and its clinical significance

Selection of Surgical Methods in the Treatment of Upper Tibia Osteosarcoma and Prognostic Analysis

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