Primary malignant bone tumors in children − possibilities of limb-saving surgery using allografts
Authors:
Martin Vlach; Jiří Schovanec; Vojtěch Havlas; Lukáš Wagenknecht; Tomáš Trč
Authors‘ workplace:
Klinika dětské a dospělé ortopedie a traumatologie 2. LF UK a FN Motol
Published in:
Čas. Lék. čes. 2016; 155: 406-412
Category:
Review Articles
Overview
Therapy of primary malignant bone tumors is always multimodal and requires close cooperation of oncologist, orthopedic surgeon, radiologist and others. In our article, we provide a brief overview of the most common malignant bone tumors in pediatric patients and summarize the commonly used therapeutic procedures. Despite advances in cancer treatment radical surgical resection of the tumor is still necessary. If possible, it should be complete removal of the affected structures, made in terms of the so-called limb-saving (limb-sparing) surgery that preserves the shape and function of the affected limb to the fullest extent possible. In addition the resection must be done at the same time with substitution of the removed bone. Bone grafts, both autografts and allografts, are used in majority of solutions. We also discuss the comparison of different approaches of limb-saving surgery compared to ablative procedures.
Keywords:
malignant tumor, bone, paediatrics, osteosarcoma, Ewing sarcoma
Sources
1. Dungl P et al. Ortopedie (2., přepracované a doplněné vydání). Grada, Praha, 2014.
2. Elsner U, Henrichs M, Goshege G et al. Forequarter amputation: a safe rescue procedure in a curative and palliative setting in high-grade malignoma of the shoulder girdle. World J Surg Oncol 2016; 14: 216.
3. Ando K, Heymann MF, Stresing V et al. Current therapeutic strategies and novel approaches in osteosarcoma. Cancers (Basel) 2013; 5: 591–616.
4. Ewing J. A review and classification of bone sarcomas, Arch Surg 1922; 4: 485–533.
5. Akagunduz O, Kamer SA, Kececi B et al. The role of radiotherapy in local control of nonextremity Ewing sarcomas. Tumori 2016; 102: 162–167.
6. Osasan S, et al. Osteogenic sarcoma: A 21st century review. Anticancer Res 2016; 9: 4391–4398.
7. Savvidou OD, Bolia IK, Chloros GD et al. Applied nanotechnology and nanoscience in orthopedic oncology. Orthopedics 2016; 39: 280–286.
8. Jin T, Wu H, Wang Y, Peng H. Capsaicin induces immunogenic cell death in human osteosarcoma cells. Exp Ther Med 2016; 12: 765−770.
9. Han G, Bi W Z, Xu M et al. Amputation versus limb-salvage surgery in patients with osteosarcoma: a meta-analysis. World J Surg 2016; 40: 2016−2027.
10. Pappo A. Pediatric Bone and Soft Tissue Sarcomas, Springer, Berlin, Heidelberg, 2006.
11. Malawer M, Sugarbaker P. Musculoskeletal Cancer Surgery, Treatment of Sarcomas and Allied Diseases, Springer, Netherlands, 2001.
12. Schovanec J, Trč T, Kotaška J, Paděra R. Diagnostika a terapie benigních kostních tumorů. Postgraduální medicína 2008; 10: 897–905.
13. Bullough PG. Orthopaedic Pathology, Mosby/Elsevier, Maryland Heights, 2010.
14. Goedhart LM, Gerbers JG, Ploegmakers JW, Jutte PC. Delay in diagnosis and Its effect on clinical outcome in high-grade sarcoma of bone: a referral oncological centre study. Orthop Surg 2016; 8: 122−128.
15. Grimer RJ. Surgical options for children with osteosarcoma. Lancet Oncol 2005; 6: 85−92.
16. Kruseová J et al. Radikální operační výkon a intenzivní chemoterapie jsou podmínkou úspěšné léčby osteosarkomu. Klin Onkol 2009; 22: 168–175.
17. Ma L, Zhou Y, Zhu Y et al. 3D-printed guiding templates for improved osteosarcoma resection. Sci Rep 2016; 6: 23335.
18. Macewen W. Observations concerning transplantation of bone. Illustrated by a case of inter-human osseous transplantation, whereby over two-thirds of the shaft of a humerus was restored. Proceedings of the Royal Society of London 1881; 32: 232–247.
19. Guillén GL, Marhuenda GC, Pellisé F et al. Thoracic wall reconstruction with bioabsorbable plates in pediatric malignant thoracic wall tumors. J Pediatr Surg 2016; pii: S0022-3468(16)30294-9.
20. Titus V, Clayer M. Protecting a patellar ligament reconstruction after proximal tibial resection: a simplified approach. Clin Orthop Relat Res 2008; 466: 1749–1754.
21. Enneking WF, Durnham WK. Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am 1996; 6: 266–267.
22. He F, Zhang W, Shen Y et al. Effects of resection margins on local recurrence of osteosarcoma in extremity and pelvis: Systematic review and meta-analysis. Int J Surg 2016; 36: 283–292.
23. Witte D, Bernd L, Bruns J et al. Limb-salvage reconstruction with MUTARS hemipelvic endoprosthesis: A prospective multicenter study. Eur J Surg Oncol (EJSO) 2009; 35: 1318–1325.
24. Kinkel S, Lehner B, Kleinhans JA et al. Medium to long-term results after reconstruction of bone defects at the knee with tumor endoprostheses. J Surg Oncol 2010; 101: 166–169.
25. Demšar I, Duhovnik J, Lešnik B, Supej M. Multi-axis prosthetic knee resembles Alpine skiing movements of an intact leg. J Sports Sci Med 2015; 14: 841–848.
26. Hargrove LJ, Simon AM, Young AJ et al. Robotic leg control with EMG decoding in an amputee with nerve transfers. N Engl J Med 2013; 369: 1237–1242.
27. Spear MA, Dupuy DE, Park JJ et al. Tolerance of autologous and allogeneic bone grafts to therapeutic radiation in humans. Int J Radiat Oncol Biol Phys 1999; 45: 1275–1280.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain managementArticle was published in
Journal of Czech Physicians
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