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A long-term follow-up study of extracorporeal irradiated autografts in limb salvage surgery for malignant bone and soft tissue tumors: A minimum follow-up of 10 years after surgery.

体外照射自体移植物在恶性骨和软组织肿瘤保肢手术中的长期随访研究: 术后至少随访 10 年。

  • 影响因子:2.88
  • DOI:10.1002/jso.25918
  • 作者列表:"Outani H","Takenaka S","Hamada K","Imura Y","Kakunaga S","Tamiya H","Wakamatsu T","Naka N","Ueda T","Araki N
  • 发表时间:2020-06-01
Abstract

BACKGROUND AND OBJECTIVES:The aim of this study is to assess the survival, function, radiographic appearance, and modes of failure of extracorporeal irradiated (ECI) autografts in a long-term setting. METHODS:We retrospectively reviewed 87 patients who were treated for bone and soft tissue tumors using ECI autografts between 1988 and 2009. RESULTS:The 56 patients had a minimum follow-up of 10 years, and the median follow-up period was 16.5 years. The reimplantation procedures included 24 osteoarticular grafts, 16 intercalary grafts, 10 autograft-prosthetic composite grafts, and 6 hemicortical grafts. The 15-year graft and event-free survival rates were 76.8% and 47.9%, respectively. Infection and structural failure were the most common reasons for additional surgery. The time for additional surgery was significantly longer in patients with composite grafts (P < .01). The median Musculoskeletal Tumor Society score and the International Society of Limb Salvage score were 80% and 84%, respectively. CONCLUSIONS:ECI autografts are a durable option for reconstruction after resection of musculoskeletal tumors and provide good function over more than 15 years. Most graft failures occurred within 5 years of the index surgery. However, composite grafts showed a tendency to fail more than 10 years after the surgery.

摘要

背景和目的: 本研究的目的是评估体外照射 (ECI) 自体移植物在长期环境中的存活、功能、影像学表现和失败模式。 方法: 我们回顾性分析了 1988 年至 2009 年间 87 例使用ECI自体移植治疗骨和软组织肿瘤的患者。 结果: 56 例患者的最小随访时间为 10 年,中位随访期为 16.5 年。再植手术包括骨关节移植物 24 例,intercal骨移植物 16 例,自体-假体复合移植物 10 例,半皮质移植物 6 例。15 年移植生存率和无事件生存率分别为 76.8% 和 47.9%。感染和结构失败是额外手术的最常见原因。复合移植物患者的额外手术时间显著延长 (p <.01)。肌肉骨骼肿瘤学会评分和国际保肢学会评分的中位数分别为 80% 和 84%。 结论: ECI自体移植是骨骼肌肉肿瘤切除后重建的一种持久选择,在超过 15 年的时间内提供良好的功能。大多数移植失败发生在指数手术的 5 年内。然而,复合移植物在术后 10 年以上显示出失败的趋势。

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发表时间:2020-03-01
DOI:10.1259/bjr.20180883
作者列表:["Tran S","Puric E","Walser M","Poel R","Datta NR","Heuberger J","Pica A","Marder D","Lomax N","Bolsi A","Morach P","Bachtiary B","Seddon BM","Schneider R","Bodis S","Weber DC"]

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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

METHODS:BACKGROUND:National guidelines recommend screening and treatment for cancer-related bone disease and continued monitoring of bone-modifying agents. It is unclear whether a standardized screening tool is utilized to identify eligible patients and ensure appropriate supportive care is implemented. The purpose of this study was to evaluate current prescribing practices and optimize management of bone-modifying agents. METHODS:A retrospective chart review was performed to identify patients who received hormone deprivation therapy or had bone metastases through Hematology/Oncology or Urology clinics from 1 November 2016 to 31 October 2017. The primary endpoints of this study were the incidence of completed baseline dual-energy X-ray absorptiometry (DEXA) scan for patients on hormone deprivation therapy and percent of patients started on a bone-modifying agent for the prevention of skeletal-related events secondary to bone metastasis. Secondary endpoints included percent of patients with dental examinations prior to initiation, adequate calcium and vitamin D supplementation, incidence of osteonecrosis of the jaw or flu-like symptoms and education, and percent of bisphosphonate doses appropriately adjusted based on renal function. RESULTS:A total of 375 patients were assessed for baseline DEXA scans and bone-modifying therapy. Of the 226 patients on hormone deprivation therapy, 111 (49%) patients were appropriately screened with a DEXA scan prior to initiation of hormone deprivation therapy. Among the 149 patients with bone metastases, only 94 (63.1%) patients were started on a bone-modifying agent. CONCLUSIONS:Opportunities have been identified to optimize management of patients with cancer-related bone disease. Implementation of standardized tools may increase the rate of appropriate screening and initiation of bone-modifying therapy when warranted.

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影响因子:2.83
发表时间:2020-01-01
DOI:10.1007/s00520-019-04843-9
作者列表:["Dohzono S","Sasaoka R","Takamatsu K","Hoshino M","Nakamura H"]

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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