Secondary hematological malignancies in patients with sarcoma: A single‑center retrospective study.

The present retrospective study investigated the clinical features and prognosis of secondary hematological malignancies (SHMs) in patients with sarcoma at Korea Cancer Center Hospital (Seoul, South Korea). Patients who had been diagnosed with SHMs after having received treatment for sarcoma between January 2000 and May 2023 were enrolled. Clinical data were collected from the patients' medical records.

Proximal Femur Salvage in Revision Knee Arthroplasty Due to Oncologic Indications: Long-term Results of Onlay and Overlapping Allograft in Revision Surgeries.

Background: Mechanical failures of tumor endoprosthesis in the distal femur usually require revision surgery. We investigated if the proximal femur host bone can be salvaged by onlay and overlapping allograft in revision surgeries due to aseptic loosening and stem fractures.

Methods: We retrospectively reviewed 18 patients (7 men and 11 women) with osteosarcoma around the knee.

The clinical outcome of hemicortical resection in extremity malignant bone tumors.

Introduction: Hemicortical resection is challenging when a huge fungating tumor is covering the osteotomy site. We report the clinical outcome of hemicortical resection and reconstruction for primary bone tumors, especially with high-grade histology and extensive circumferential involvement.

Materials And Methods: We retrospectively reviewed 44 patients (males, n = 18; females, n = 26) who underwent hemicortical resection from 2005 to 2014.

Clinical outcomes of endoprosthetic reconstruction for proximal femoral resection.

Introduction: The proximal femur is a common site for primary sarcomas and metastatic lesions. Although the early results of tumor prostheses are promising, the long-term results of reconstruction are unknown. The purpose of this study is to evaluate the prognostic factors affecting prosthesis survival and complications after proximal femoral resection and reconstruction.

Early response monitoring of neoadjuvant chemotherapy using [F]FDG PET can predict the clinical outcome of extremity osteosarcoma.

Background: To propose a personalized therapeutic approach in osteosarcoma treatment, we assessed whether sequential [F]FDG PET/CT (PET/CT) could predict the outcome of patients with osteosarcoma of the extremities after one cycle and two cycles of neoadjuvant chemotherapy.

Methods: A total of 73 patients with AJCC stage II extremity osteosarcoma treated with 2 cycles of neoadjuvant chemotherapy, surgery, and adjuvant chemotherapy were retrospectively analyzed in this study. All patients underwent PET/CT before (PET0), after 1 cycle (PET1), and after the completion of neoadjuvant chemotherapy (PET2), respectively.

Metastasis risk prediction model in osteosarcoma using metabolic imaging phenotypes: A multivariable radiomics model.

Background: Osteosarcoma (OS) is the most common primary bone tumor affecting humans and it has extreme heterogeneity. Despite modern therapy, it recurs in approximately 30-40% of patients initially diagnosed with no metastatic disease, with the long-term survival rates of patients with recurrent OS being generally 20%. Thus, early prediction of metastases in OS management plans is crucial for better-adapted treatments and survival rates.

Are Pasteurized Autografts Durable for Reconstructions After Bone Tumor Resections?

Background: Pasteurized autograft is regarded as a biologic reconstructive option for managing bone defects after tumor resection; however, reports on long-term outcomes from large patient series are scarce. Contrary to previous favorable reports, we have observed many patients with failures, in particular as the duration of followup increased. Because pasteurized autografts are used in many countries as a reconstruction option, we wished to formally evaluate patients who underwent this approach at one specialty center.

Comparison of 99mTc-methyl diphosphonate bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography to predict histologic response to neoadjuvant chemotherapy in patients with osteosarcoma.

We compared the usefulness of Tc-methyl diphosphonate (Tc-MDP) bone scintigraphy and F-fluorodeoxyglucose (FDG) for positron emission tomography/computed tomography (PET/CT) in predicting histologic response in patients with osteosarcoma receiving neoadjuvant chemotherapy (NAC).We retrospectively reviewed 62 patients with high-grade osteosarcoma who had received 2 cycles of NAC and surgery. All patients underwent Tc-MDP bone scintigraphy and F-FDG PET/CT before and after NAC.

Comparison of Pasteurized Autograft-Prosthesis Composite Reconstruction and Resection Hip Arthroplasty for Periacetabular Tumors.

Background: Because of the high complication rate of anatomical reconstruction after periacetabular resection, the strategy of resection alone has been revisited. However, in terms of complications and functional outcome, whether resection hip arthroplasty (RHA) shows a superior result to that of pelvic ring reconstruction remains controversial.

Methods: We compared 24 RHAs and 16 pasteurized autograft-prosthesis composite (PPC) reconstructions regarding the complication rates, operative time, blood loss, and functional outcome.

Pasteurized Autograft-Prosthesis Composite Reconstruction May Not Be a Viable Primary Procedure for Large Skeletal Defects after Resection of Sarcoma.

Background: Among various types of composite biological reconstruction, pasteurized autograft-prosthesis composite (PPC) is popular when allograft is unavailable. Previous limited cohort study indicated result comparable to tumor prosthesis. However, as case number and follow-up increase, we experienced more complications than anticipated.

Higher Gemcitabine Dose Was Associated With Better Outcome of Osteosarcoma Patients Receiving Gemcitabine-Docetaxel Chemotherapy.

Background: Efficacy of gemcitabine and docetaxel (GEM + DOC) chemotherapy in patients with recurrent or refractory osteosarcoma was evaluated.

Methods: Data of 53 patients from 9 institutions, who received GEM (675 or 900 mg/m(2) on days 1 and 8) and DOC (100 mg/m(2) on day 8), were retrospectively reviewed.

Results: GEM + DOC was administered as adjuvant (n = 25) or palliative chemotherapy (n = 28).

Efficacy of pamidronate in pediatric osteosarcoma patients with low bone mineral density.

Purpose: Most surviving pediatric osteosarcoma patients experience osteoporosis, bone pain, and pathologic fracture during and after therapy. The aim of this study was to evaluate the efficacy and side effects of pamidronate therapy in these patients.

Methods: Nine osteosarcoma patients (12.

Bone mineral density change during adjuvant chemotherapy in pediatric osteosarcoma.

Purpose: Osteoporosis is currently receiving particular attention as a sequela in survivors of childhood osteosarcoma. The aim of this study was to evaluate bone mineral density (BMD) changes during methotrexate-based chemotherapy in children and adolescents with osteosarcoma.

Methods: Nine patients with osteosarcoma were included in this retrospective study and compared with eight healthy controls.

Development and external validation of nomograms predicting distant metastases and overall survival after neoadjuvant chemotherapy and surgery for patients with nonmetastatic osteosarcoma: A multi-institutional study.

Background: In this era of individualized cancer treatment, data that could be applied to predicting the survival of patients with osteosarcoma are still limited because of the rarity of the disease and the difficulty in accumulating a sufficient number of patients. Therefore, a multi-institutional collaboration was implemented to develop and externally validate nomograms that would predict metastasis-free survival (MFS) and overall survival (OAS) for patients with nonmetastatic osteosarcoma.

Methods: This study retrospectively examined 1070 patients treated with neoadjuvant chemotherapy and surgery for nonmetastatic osteosarcoma.

Temporary hemiarthroplasty with a synthetic device in children with osteosarcoma around the knee as a bridging procedure until skeletal maturity.

Background: We hypothesized that hemiarthroplasty with a synthetic device in skeletally immature patients with osteosarcoma around the knee would be functional due to high adaptability in the pediatric age group, and may decrease the number of surgeries until limb equalization by preserving the nearby physis.

Methods: We analyzed the outcomes of 25 hemiarthroplasties (12 distal femur, 13 proximal tibia). Average patient age was 11.

Clinical outcome of low-grade central osteosarcoma and role of CDK4 and MDM2 immunohistochemistry as a diagnostic adjunct.

Introduction: Low-grade osteosarcoma encompasses parosteal osteosarcoma (POS) and low-grade central osteosarcoma (LCOS), with LCOS more rare than POS. LCOS is also more likely to be misdiagnosed and inappropriately treated with an intralesional procedure, due to its misleading radiological features and the overlap of its pathological characteristics with those of benign bone tumors. Therefore, as a diagnostic adjunct for LCOS, immunohistochemical assay with murine double-minute type 2 (MDM2) and cyclin-dependent kinase 4 (CDK4) have been tried with controversial results.

Prediction of response to neoadjuvant chemotherapy in osteosarcoma using dual-phase (18)F-FDG PET/CT.

Objectives: We evaluated the ability of dual-phase (18)F-FDG PET/CT to predict the histological response after neoadjuvant chemotherapy (NAC) in osteosarcoma.

Methods: Thirty-one patients with osteosarcoma treated with NAC and surgery were prospectively enrolled. After injection of (18)F-FDG, both early (~60 min) and delayed (~150 min) PET were acquired before and after the completion of NAC.

Usefulness of increased 18F-FDG uptake for detecting local recurrence in patients with extremity osteosarcoma treated with surgical resection and endoprosthetic replacement.

Objective: To investigate the changes of increased F-18 fluorodeoxyglucose ((18)F-FDG) uptake around the prosthesis and its ability to differentiate local recurrence from postsurgical change after endoprosthetic replacement in extremity osteosarcoma.

Materials And Methods: A total of 355 positron emission tomography (PET)/computed tomography (CT) scans in 109 extremity osteosarcoma patients were retrospectively analyzed. All patients were followed up with (18)F-FDG PET/CT for more than 3 years after tumor resection.

Spontaneous necrosis and additional tumor necrosis induced by preoperative chemotherapy for osteosarcoma: a case-control study.

Background: Extent of spontaneous necrosis in untreated osteosarcoma may imply tumor aggressiveness. Reports regarding this issue are scarce and there are several points to be clarified; (1) the correlation between tumor size and extent of spontaneous necrosis displayed was conflicting, (2) whether there is difference in necrosis rate between intra- and extra-medullary portion of tumor is not described, if it does, its relation with other clinico-pathologic variables, (3) in patients with surgical treatment only, >20 % spontaneous necrosis was a poor prognostic factor, however, whether that cutoff is still valid in chemotherapy cohort remains to be determined, (4) expected additional tumor necrosis by chemotherapy was made by simply comparing the necrosis rates of untreated and treated osteosarcoma cohort.

Methods: We evaluated spontaneous necrosis in 43 osteosarcoma patients (39 Stage IIB, 4 Stage III).

Plain radiologic findings and chronological changes of incipient phase osteosarcoma overlooked by primary physicians.

Background: We assessed the plain radiographic characteristics of 10 cases of osteosarcomas during the initial painful period that had been overlooked by a primary physician. In addition, we evaluated chronologic changes in radiographic findings from initial symptomatic period to the time of accurate diagnosis.

Methods: The clinical records were reviewed for clinical parameters including age, sex, location, presenting symptoms, initial diagnosis, duration from initial symptoms to definite diagnosis, and initial and follow-up plain radiographic findings of the lesion.

Overlapping allograft for primary or salvage bone tumor reconstruction.

Background: Compared with end-to-end allograft coaptation, overlapping allograft offer a superior union rate by increasing the contact area. However, reports on overlapping allograft are scarce. Therefore, we attempted to confirm the usefulness of this technique either after primary tumor resection or in salvaging a failed reconstruction.

Early response monitoring to neoadjuvant chemotherapy in osteosarcoma using sequential ¹⁸F-FDG PET/CT and MRI.

Purpose: We evaluated the potential of sequential fluorine-18 fluorodeoxyglucose ((18) F-FDG) positron emission tomography (PET)/computed tomography (CT) and MRI (PET/MRI) after one cycle of neoadjuvant chemotherapy to predict a poor histologic response in osteosarcoma.

Methods: A prospective study was conducted on 30 patients with osteosarcoma treated with two cycles of neoadjuvant chemotherapy and surgery. All patients underwent PET/MRI before, after one cycle, and after the completion of neoadjuvant chemotherapy, respectively.

Correlation between fluid-fluid levels on initial MRI and the response to chemotherapy in stage IIb osteosarcoma.

Background: The presence of fluid-fluid levels (FFLs) on osteosarcoma magnetic resonance imaging (MRI) is underestimated as a nonspecific finding; however, we hypothesized that FFL in conventional osteosarcoma may be indicative of chemoresistance.

Methods: In 567 stage IIB osteosarcoma patients, we evaluated the following: the incidence of FFL and their correlation with other clinicopathological variables; tumor volume change after chemotherapy and survival according to the presence of FFL; and the relationship between survival and the extent of FFL.

Results: One hundred eight (19 %) tumors showed FFL on initial MRI.

Proximal tumor location and fluid-fluid levels on MRI predict resistance to chemotherapy in stage IIB osteosarcoma.

Background: Primary tumor growth during neoadjuvant chemotherapy is believed to be a sign of resistance to chemotherapy (chemoresistance), and often is associated with poor histologic response, local recurrence, and poorer survival. Currently there are no proven indicators to predict poor response to chemotherapy at the time of diagnosis.

Questions/purposes: We asked (1) what clinicopathologic factors present at diagnosis predict primary tumor growth during neoadjuvant chemotherapy, (2) what factors at presentation predict survival, and (3) when the factors at presentation and the treatment-related factors are considered, what factors independently correlate with survival.