Chondrosarcoma of the Proximal Humerus: Does the Margin Affect Survival?

Chondrosarcoma (CS) is the second most common primary malignant bone tumour and, in the absence of reliable chemotherapy and radiotherapy, is effectively a surgical disease. Overall disease specific survival (DSS) is affected by tumour grade, whilst resection margin contributes to local recurrence free survival (LRFS). The aim of this study was to investigate factors that affect the local and systemic prognoses for conventional central CSs arising from the proximal humerus.

Complete tumor necrosis after neoadjuvant chemotherapy defines good responders in patients with Ewing sarcoma.

Background: Survival in patients who have Ewing sarcoma is correlated with postchemotherapy response (tumor necrosis). This treatment response has been categorized as the response rate, similar to what has been used in osteosarcoma. There is controversy regarding whether this is appropriate or whether it should be a dichotomy of complete versus incomplete response, given how important a complete response is for in overall survival of patients with Ewing sarcoma.

[Chondrosarcoma of bone in young patients].

Chondrosarcoma is the second most frequent primary malignant bone tumor. It is typically described in adults between 40 and 70 years of age, being the majority of the series published in this age group. The objective of this study was to report a series of young adults (16-40 years old) with a diagnosis of chondrosarcoma of bone in order to describe the particularities of this tumor in this population.

[Women's role in Orthopedic Training programs: What Proportion Do They Represent Today?].

Introduction: The objective of the study was to analyze all orthopedics residency programs of Argentina and determine:1)The proportion of females; 2) Social and demographics differences between genders: 3) The factors that influence positively or negatively in female decision to choose orthopedics.

Method: An observational and descriptive study was carried out in two phases. First phase: analyze the database of the “Argentine Orthopedic Association during the period 2016-2017.

Navigated multiplanar osteotomies for spinal primary bone tumors.

Background: Establishing the proper diagnosis and rendering appropriate treatment of spinal primary bone tumors (SPBT) can result in definitive cures. Notably, malignant, or benign SPBT (i.e.

[Denosumab as a treatment for giant cell tumor of bone. Indications, results and side effects].

Giant cell tumor of bone is an intermediate, locally aggressive and rarely metastasizing, primary bone neoplasia. In recent years denosumab emerged as a treatment alternative for this pathology. The objective of this work was to analyze its indications as well as the clinical outcomes, side effects and local recurrence rates in patients diagnosed with giant cell tumor of bone, who received denosumab as neoadjuvant treatment.

Profiling of three H3F3A-mutated and denosumab-treated giant cell tumors of bone points to diverging pathways during progression and malignant transformation.

Giant cell tumor of bone (GCTB) is a locally aggressive lesion of intermediate malignancy. Malignant transformation of GCTB is a rare event. In 2013, the humanized monoclonal antibody against receptor activator of nuclear factor-κb-Ligand (RANKL) denosumab was approved for treatment of advanced GCTB.

[La Scientific activity in a highly complex center: What, who, where and how much is published?].

Introduction: We proposed to analyze the scientific production of our institution, through the publications indexed in the PUBMED and analyze: a) Total number of publications and progression over time; b) Type of publications; c) Unit participation; d) Relation between % publications / % medical unit staff; e) Impact factor.

Methods: A retrospective research was performed in PUBMED database between 1/1/2013 and 12/31/2018 and all the papers that respond to the affiliation name of "Hospital Italiano" (spanish) o "Italian Hospital" (english) were reviewed. The following information was collected from each publication: authors, journal, impact factor, unit involved and language of publication.

Computer-assisted surgery (CAS) in orthopedic oncology. Which were the indications, problems and results in our first consecutive 203 patients?

Aims: to review a group of patients with primary bone tumors treated with intraoperative navigation and analyze: (1) The technical problems; (2) Indications for Computer Assisted Surgery (CAS); (3) Oncological results; (4) Non oncological complications.

Materials And Methods: All patients from a single institution who had preoperative virtual planned for an oncological primary bone resection assisted with navigation between May 2010 and July 2017 were enrolled in the study (203 patients). The use of computer-assisted surgery (CAS) was classified according to the oncologic procedure performed: (1) intralesional resections, (2) en-block resections, and (3) en-block resections + navigated allograft reconstructions.

Does Osteoarticular Allograft Reconstruction Achieve Long-term Survivorship after En Bloc Resection of Grade 3 Giant Cell Tumor of Bone?

Background: En bloc resection of benign tumors is only indicated in aggressive lesions with substantial destruction of the affected bone. Few reports have evaluated the long-term outcome of Grade 3 giant cell tumor of bone (GCTB; defined as severe bone destruction and soft tissue extension) treated with en bloc resection and reconstruction with a massive allograft. We recently reported that patients with benign tumors achieved better allograft reconstruction survivorship compared with those treated for a malignant bone tumor.

Long-Term Clinical Outcomes of Intercalary Allograft Reconstruction for Lower-Extremity Bone Tumors.

Background: Improved survival rates for patients with primary bone tumors of the extremities have increased the demand for reliable and durable reconstruction techniques. Some authors have stated that, after successful ingrowth, allografts are a durable long-term solution. This hypothesis is largely based on small studies with short-to-midterm follow-up.

Soft tissue sarcomas in infants. Case series.

Soft tissue sarcomas in children under 2 years of age are infrequent. During 2007-2017, a total of 445 patients diagnosed with soft tissue sarcomas were treated at our institution, 6(0.5%) were under 2 years.

Do Massive Allograft Reconstructions for Tumors of the Femur and Tibia Survive 10 or More Years after Implantation?

Background: Massive bone allografts have been used for limb salvage in patients undergoing bone tumor resections as an alternative to endoprostheses. Although several studies on massive allograft reconstructions for bone tumors reported that most complications occur in the first 3 years after surgery, there are no long-term reports on complications to substantiate this contention. We believe such information is important so that surgeons and patients can make more informed decisions when choosing a reconstructive method after tumor resection.

Face to Face Appointment vs. Telemedicine in First Time Appointment Orthopedic Oncology Patients: A Cost Analysis.

Medicine has evolved considerably in recent decades in part thanks to information and communication technologies in health (ICTs). However, face-to-face consultations continue to be the predominant model, since alternatives such as telemedicine are still the subject of debate. On the other hand, in some very specific specialties, centralization is relevant, mainly due to the low frequency and prevalence of diseases, as well as the need to have highly specialized professionals, causing problems in terms of accessibility and costs for the health system.

Modular prosthesis reconstruction after tumour resection, evaluation of failures and survival.

Objective: To analyze a series of patients with bone tumours reconstructed with modular prostheses and to evaluate: 1) Survival of the implant. 2) Causes of failure. 3) Complication rates.

Proximal humerus chondrosarcoma.Long-term clinical and oncological outcomes.

Introduction: The proximal humerus is a common site for primary bone sarcomas, of which chondrosarcoma represents 15%. There are few reports about this select group of tumours. We set out to analyse a group of patients with proximal humerus chondrosarcoma treated with surgery and to assess their long term surgical and oncological outcomes.

Failure rates and functional results for intercalary femur reconstructions after tumour resection.

Purpose: To compare the results for patients treated with intercalary endoprosthetic replacement (EPR) or intercalary allograft reconstruction for diaphyseal tumours of the femur in terms of: (1) reconstruction failure rates; (2) cause of failure; (3) risk of amputation of the limb; and (4) functional result.

Methods: Patients with bone sarcomas of the femoral diaphysis, treated with en bloc resection and reconstructed with an intercalary EPR or allograft, were reviewed. A total of 107 patients were included in the study (36 EPR and 71 intercalary allograft reconstruction).

Virtual Planning and Allograft Preparation Guided by Navigation for Reconstructive Oncologic Surgery: A Technical Report.

Introduction: Advanced virtual simulators can be used to accurately detect the best allograft according to size and shape.

Step 1 Acquisition Of Medical Images: Obtain a multislice CT scan and a magnetic resonance imaging (MRI) scan preoperatively for each patient; however, if the time between the scans and the surgery is >1 month, consider repeating the MRI because the size of the tumor may have changed during that time.

Step 2 Select An Allograft Using Virtual Imaging To Optimize Size Matching:

Step 3 Plan And Outline The Tumor Margins On The Preoperative Imaging: Determine and outline the tumor margin on manually fused CT and MRI studies using the registration tool of the mediCAS planning software or equivalent (Materialise Mimics software.

Analysis of the order-implantation relationship for musculoskeletal tissue transplantation.

Objective: To analyze orders requested from a musculoskeletal tissue bank and to evaluate the percentage of tissue implantation.

Material And Methods: Two hundred and sixty-five orders for musculoskeletal tissue were analyzed over the course of a year.

Exclusions: 5 duplications and 5 orders for which there was no availability to cover the need.

What Are the Complications of Allograft Reconstructions for Sarcoma Resection in Children Younger Than 10 Years at Long-term Followup?

Background: Preservation of limb function after resection of malignant bone tumors in skeletally immature children is challenging. Resection of bone sarcomas and reconstruction with an allograft in patients younger than 10 years old is one reconstructive alternative. However, long-term studies analyzing late complications and limb length discrepancy at skeletal maturity are scarce; this information would be important, because growth potential is altered in these patients owing to the loss of one physis during tumor resection.

Is Navigation-guided En Bloc Resection Advantageous Compared With Intralesional Curettage for Locally Aggressive Bone Tumors?

Background: The treatment of locally aggressive bone tumors is a balance between achieving local tumor control and surgical morbidity. Wide resection decreases the likelihood of local recurrence, although wide resection may result in more complications than would happen after curettage. Navigation-assisted surgery may allow more precise resection, perhaps making it possible to expand the procedure's indications and decrease the likelihood of recurrence; however, to our knowledge, comparative studies have not been performed.