Calcium phosphate cement and locked plate augmentation of distal femoral defects: A biomechanical analysis.

Purpose: Bone tumors are common in the distal femur and often treated with intralesional curettage. The optimal method of stabilization of large distal femoral defects after curettage remains unclear. The goal of this study is to compare stabilization techniques for large distal femoral defects.

Torsional properties of distal femoral cortical defects.

The optimal management of pathologic long bone lesions remains a challenge in orthopedic surgery. The goal of the current study was to investigate the effect of defect depth on the torsional properties of the distal femur. A laterally placed distal metaphyseal cylindrical defect was milled in the cortex of the distal femur in 20 composite models.

Giant cell tumor of bone.

EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Identify at-risk populations for giant cell tumor of bone. 2.

Phase I trial of neoadjuvant conformal radiotherapy plus sorafenib for patients with locally advanced soft tissue sarcoma of the extremity.

Background: Despite effective local therapy with surgery and radiotherapy (RT), ~50 % of patients with high-grade soft tissue sarcoma (STS) will relapse and die of disease. Since experimental data suggest a significant synergistic effect when antiangiogenic targeted therapies such as sorafenib are combined with RT, we chose to evaluate preoperative combined modality sorafenib and conformal RT in a phase I/II trial among patients with extremity STS amenable to treatment with curative intent.

Methods: For the phase I trial, eight patients with intermediate- or high-grade STS >5 cm in maximal dimension or low-grade STS >8 cm in maximal dimension received concomitant sorafenib (dose escalation cohort 1:200 twice daily, cohort 2:200/400 daily) and preoperative RT (50 Gy in 25 fractions).

Influence of physician specialty on treatment recommendations in the multidisciplinary management of soft tissue sarcoma of the extremities.

Importance: Although prospective randomized data are available to guide the multidisciplinary management of soft tissue sarcoma (STS) of the extremities, controversy exists regarding adjuvant chemotherapy and radiation therapy.

Objective: To determine if clinical specialty introduces bias in recommendations for multimodality treatment of STS.

Design: Electronic survey.

Complete pathologic response to neoadjuvant radiotherapy is predictive of oncological outcome in patients with soft tissue sarcoma.

Unlabelled: We sought to determine if complete pathological necrosis (pathCR) predicts favorable oncological outcome in soft tissue sarcoma (STS) patients receiving pre-operative radiation monotherapy (RT).

Patients And Methods: We evaluated 30 patients with primary STS treated with neoadjuvant RT followed by definitive resection, from 2000 to 2010 at our institution. We defined ≥ 95% tumor necrosis as pathCR.

P16 expression predicts necrotic response among patients with osteosarcoma receiving neoadjuvant chemotherapy.

Although pathologic response to neoadjuvant chemotherapy is highly correlated with survival among patients with osteosarcoma, there are currently no established molecular markers to predict response to chemotherapy. The objective of this study was to investigate the relationship of P16 expression in pretreatment osteosarcoma tumors to pathologic necrotic response after neoadjuvant chemotherapy. A tissue microarray was created from paraffin-embedded pretreatment biopsy specimens of 40 patients with osteosarcoma.

Pelvic osteoid osteoma in a skeletally mature female.

Osteoid osteoma is the most common bone-producing tumor that typically presents with "throbbing night pain" and that improves dramatically with use of low-dose salicylates. Few cases of pelvic osteoid osteoma have been reported, and most have involved patients younger than age 30. Surgical excision classically has been the treatment of choice, but, recently, less invasive modalities, including radiofrequency ablation, have begun to supplant surgical management of osteoid osteoma, resulting in a decrease in the need for definitive surgical diagnosis and treatment.

Predicting survival for well-differentiated liposarcoma: the importance of tumor location.

Background: Although well-differentiated liposarcoma (WD Lipo) is a low grade neoplasm with a negligible risk of metastatic disease, it can be locally aggressive. We hypothesized that survival for WD Lipo varies significantly based on tumor location.

Methods: We identified 1266 patients with WD Lipo in the Surveillance, Epidemiology, and End Results database from 1988-2004.

Influence of specialty and clinical experience on treatment sequencing in the multimodal management of soft tissue extremity sarcoma.

Purpose: Although multimodal management of extremity soft tissue sarcoma (STS) is the standard of care, considerable variation exists in the sequencing of radiotherapy (RT) or chemotherapy (CT). Our goal was to identify factors responsible for this variation.

Methods: Members of specialty societies with an interest in STS were emailed a questionnaire about multimodal treatment of STS.

Lack of survival benefit following adjuvant radiation in patients with retroperitoneal sarcoma: a SEER analysis.

Background: The benefit of radiation therapy (RT) among patients with retroperitoneal sarcoma (RPS) is controversial. We performed a retrospective analysis of the effect of RT on survival among RPS patients using a nationwide cancer registry.

Methods: Utilizing data from the Surveillance, Epidemiology, and End Results (SEER) database, we identified 2308 cases of RPS from 1988 to 2004.

Contiguous organ resection is safe in patients with retroperitoneal sarcoma: An ACS-NSQIP analysis.

Background And Objectives: The practice of aggressive contiguous organ resection (COR) of retroperitoneal sarcoma (RPS) is controversial. We examined rates of 30-day morbidity and mortality following resection of RPS utilizing data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.

Methods: From 2005 to 2007, we identified 156 cases of primary malignant neoplasm of the retroperitoneum.

Histologic type predicts survival in patients with retroperitoneal soft tissue sarcoma.

Background: Histologic grade, completeness of resection, and presence of metastases are traditionally regarded as the primary factors in predicting survival for retroperitoneal soft tissue sarcoma (RPSTS). We sought to examine the importance of histologic type as a prognostic factor among patients with RPSTS.

Methods: We identified 2337 cases of RPSTS in the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2004.

Progression of aggressive metastatic carcinosarcoma after treatment of epithelioid osteosarcoma.

Osteosarcoma is the most common primary malignant osseous neoplasm, constituting approximately 35% of skeletal malignancies. The different subtypes of osteosarcoma are differentiated based on clinical, histologic, and radiographic data, as well as the variable amount of osteoid produced by malignant cells. The epithelioid osteosarcoma subtype accounts for only 5.

Radiographic and histologic response to neoadjuvant radiotherapy in patients with soft tissue sarcoma.

Background: Limited data exist regarding the radiographic and histologic response of soft tissue sarcoma (STS) to neoadjuvant radiotherapy (RT).

Methods: Between February 2000 and January 2009, a total of 25 patients aged >16 years with intermediate- or high-grade primary STS of all sites were treated with neoadjuvant RT followed by definitive resection. Patients receiving chemoradiotherapy were excluded.

Amputations of the hand and upper extremity in the management of malignant tumors.

The primary goal of treatment for malignant bone and soft tissue tumors of the hand and upper extremity is an oncologic cure. The secondary goal is maintenance of function. Despite recent advances in chemotherapy and radiation techniques, amputation still provides a means for achieving surgical cure for some bone and soft tissue sarcomas.

The role of arthroscopic synovectomy in the management of hemarthrosis in hemophilia patients: financial perspectives.

Purpose: The purpose of this study was to determine the financial efficacy of arthroscopic synovectomy in hemophilia patients with recurrent hemarthroses.

Type Of Study: Cost-benefit analysis.

Methods: A retrospective chart review from 1993 through 1999 yielded 11 cases of arthroscopic synovectomies performed for recurrent hemarthroses at the University of Michigan.