Evaluation of primary high-grade osteosarcoma by surgical resection in PT Birta city hospital
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20242383Keywords:
OS, Wide resection, Surgical resection, ChemotherapyAbstract
Background: Classic OS had a 20% five-year survival rate during most of the 20th century. Adjuvant chemotherapy was first used to treat OS in the 1970s, raising survival rates to 50%. The standard course of treatment for OS includes surgery, neoadjuvant chemotherapy, and adjuvant chemotherapy. When treating a patient with soft tissue and bone sarcomas, the extent of surgical procedures is frequently described using surgical oncologic classifications. Radical resection refers to the removal of the whole bone or compartment harboring the tumor, whereas wide resection refers to the removal of the affected area of the bones with a cuff of healthy tissue.
Methods: The study conducted a retrospective analysis of 120 patients who visited to orthopedic outpatient department of PT Birta city hospital and research center, Nepal from October 2019 to November 2022. Radical resection was defined as the removal of the entire affected bone, while wide resection was described as partial bone excision. The baseline characteristics of the patients were analyzed and the data regarding radical and wide resection in osteosarcoma (OS) was evaluated.
Results: The analyzed report shows that 65/120 (54.1%) radical resections and 55/120 (45.8%) wide excisions were the extent of the resection. On the other hand, a central review of the extent of resection data revealed 100/120 (83.3%) wide excisions and 20/120 (16.6%) radical resections.
Conclusions: OS is currently treated with extensive resection, neoadjuvant chemotherapy, and adjuvant chemotherapy, with a strict emphasis on the overall intensity of treatment and prompt restart of post-resection chemotherapy.
References
Mirabello L, Troisi RJ, Savage SA. International osteosarcoma incidence patterns in children and adolescents, middle ages and elderly persons. Int J Cancer. 2009;125(1):229-34.
Harvei S, Solheim Ø. The prognosis in osteosarcoma: Norwegian national data. Cancer, 1981;48(8):1719-23.
Eilber F, Giuliano A, Eckardt J, Patterson K, Moseley S, Goodnight J. Adjuvant chemotherapy for osteosarcoma: a randomized prospective trial. J Clin Oncolo. 1987;5(1):21-6
Simon MA, Aschliman MA, Thomas N, Mankin HJ. Limb-salvage treatment versus amputation for osteosarcoma of the distal end of the femur. J Bone Joint Surg Am. 1986;198668(9):1331-7.
Ozaki T, Flege S, Liljenqvist U, Hillmann A, Delling G, Salzer-Kuntschik M, et al. Osteosarcoma of the spine: experience of the Cooperative Osteosarcoma Study Group. Cancer. 2002;94(4):1069-77.
Geller DS, Gorlick R. Osteosarcoma: a review of diagnosis, management, and treatment strategies. Clin Advanc Hematol Oncol. 2010;8(10):705-18.
Aboulafia AJ, Malawer MM. Surgical management of pelvic and extremity osteosarcoma. Cancer. 1993;71(S10):3358-66.
Geller DS, Gorlick R. Osteosarcoma: a review of diagnosis, management, and treatment strategies. Clin Advanc Hematol Oncol. 2010;8(10):705-18.
Betz M, Dumont CE, Fuchs B, Exner GU. Physeal distraction for joint preservation in malignant metaphyseal bone tumors in children. Clin Orthop Rel Res. 2012;470(6):1749-54.
Bacci G, Ferrari S, Longhi A, Forni C, Bertoni F, Fabbri N, et al. Neoadjuvant Chemotherapy for High Grade Osteosarcoma of the Extremities: Long-Term Results for Patients Treated According to the Rizzoli IOR/OS-3b Protocol. J Chemotherapy. 2001;13(1):93-9.
Ferrari S, Palmerini E, Staals EL, Mercuri M, Franco B, Picci P, et al. The treatment of nonmetastatic high grade osteosarcoma of the extremity: review of the Italian Rizzoli experience. Impact on the future. Cancer Treat Res. 2009;152:275-87.
Watts HG. Introduction to resection of musculoskeletal sarcomas. Clin Orthop Rel Res. 1980;153:31-8.
Finn HA, Simon MA. Limb-salvage surgery in the treatment of osteosarcoma in skeletally immature individuals. Clin Orthop Rel Res. 1991;262:108-18.
Han G, Bi WZ, Xu M, Jia JP, Wang Y. Amputation Versus Limb-Salvage Surgery in Patients with Osteosarcoma: A Meta-analysis. World J Surg. 2016;40(8):2016-27.
Gm O, Ka C, Em W. Perioperative chemotherapy in the treatment of osteosarcoma: a 26-year single institution review. Clin Sarcoma Res. 2015;5:10.
Enneking W, Dunham W, Gebhardt M, Malawar M, Pritchard D. A system for the classification of skeletal resections. La Chirurgia Degli Organi Di Movimento. 1990;75(1):217-40.
Morris CD, Teot LA, Bernstein ML, Marina N, Krailo MD, Villaluna D, et al. Assessment of extent of surgical resection of primary high-grade osteosarcoma by treating institutions: A report from the Children’s Oncology Group. J Surg Oncol. 2016;113(4):351-4.
Gherlinzoni F, Picci P, Bacci G, Campanacci D. Limb sparing versus amputation in osteosarcoma. Ann Oncol. 1992;3:S23-7.
Bernthal NM, Federman N, Eilber FR, Nelson SD, Eckardt JJ, Eilber FC, et al. Long-term results (>25 years) of a randomized, prospective clinical trial evaluating chemotherapy in patients with high-grade, operable osteosarcoma. Cancer. 2012;118(23):5888-93.
Trovik CS, Skjeldal S, Bauer H, Rydholm A, Jebsen N. Reliability of Margin Assessment after Surgery for Extremity Soft Tissue Sarcoma: The SSG Experience. Sarcoma. 2012;8:1-5.
Kawaguchi N, Matumoto S, Manabe J. New method of evaluating the surgical margin and safety margin for musculoskeletal sarcoma, analysed on the basis of 457 surgical cases. J Cancer Res Clin Oncol. 1995;121(9-10):555-63.
Kim JH, Kang HG, Kim HS. MRI-guided Navigation Surgery with Temporary Implantable Bone Markers in Limb Salvage for Sarcoma. Clin Orthopaed Rel Res. 2010;468(8):2211-7.
Cañadell J, Forriol F, Cara JA. Removal of metaphyseal bone tumours with preservation of the epiphysis. Physeal distraction before excision. J Bone Joint Surg Brit Vol. 1994;76(1):127-32.
Palumbo BT, Henderson ER, Groundland JS, Cheong D, Pala E, Letson GD, et sl. Advances in Segmental Endoprosthetic Reconstruction for Extremity Tumors: A Review of Contemporary Designs and Techniques. Cancer Control. 2011;18(3):160-70.
Muscolo DL, Ayerza MA, Aponte-Tinao L, Farfalli G. Allograft Reconstruction After Sarcoma Resection in Children Younger Than 10 Years Old. Clin Orthop Rel Res. 2008;466(8):1856-62.
