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Deng GH, Wang H, Tan Z, Chen R. Risk factors for distant metastasis of chondrosarcoma: A population-based study. Medicine (Baltimore) 2023; 102:e35259. [PMID: 37713884 PMCID: PMC10508579 DOI: 10.1097/md.0000000000035259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/25/2023] [Indexed: 09/17/2023] Open
Abstract
Chondrosarcoma is the second largest bone malignancy after osteosarcoma and mainly affects middle-aged adults, where patients with distant metastasis (DM) often have a poor prognosis. Although nomograms have been widely used to predict distant tumor metastases, there is a lack of large-scale data studies for the diagnostic evaluation of DM in chondrosarcoma. Data on patients diagnosed with chondrosarcoma from 2004 to 2015 were obtained from the Surveillance, Epidemiology, and End Results database. Independent risk factors for having DM from chondrosarcoma were screened using univariate and multivariate logistics regression analysis. A nomogram was created to predict the probability of DM from the screened independent risk factors. The nomogram was then validated using receiver operating characteristic curves and calibration curves. A total of 1870 chondrosarcoma patients were included in the study after data screening, of which 157 patients (8.40%) had DM at the time of diagnosis. Univariate and multivariate logistic regression analysis screened four independent risk factors, including grade, tumor number, T stage, and N stage. receiver operating characteristic curves and calibration curves showed good accuracy of the nomogram in both training and validation sets. The current study screened for independent risk factors for DM from chondrosarcoma, which will help clinicians evaluate patients.
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Affiliation(s)
- Guang-Hua Deng
- Ya’an Hospital of Traditional Chinese Medicine, Yaan, Sichuan, China
| | - Hong Wang
- Ya’an Hospital of Traditional Chinese Medicine, Yaan, Sichuan, China
| | - Zhe Tan
- Ya’an Hospital of Traditional Chinese Medicine, Yaan, Sichuan, China
| | - Rong Chen
- Ya’an Hospital of Traditional Chinese Medicine, Yaan, Sichuan, China
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Long-term outcomes of non-invasive expandable endoprostheses for primary malignant tumors around the knee in skeletally-immature patients. Arch Orthop Trauma Surg 2022; 142:927-936. [PMID: 33417027 DOI: 10.1007/s00402-020-03712-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 12/06/2020] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Expandable endoprostheses are used to restore limb function and compensate for the sacrifice physis involved in carcinologic resection. Long-term outcomes of the last generation of knee "non-invasive" expandable endoprostheses are required. Objectives were to report on oncologic results of bone sarcoma resection around the knee with expandable endoprosthesis reconstruction and to compare the surgical outcomes of the "non-invasive" expandable endoprostheses used in our department. MATERIALS AND METHODS Retrospective study that included all children with bone sarcoma around the knee that underwent tumor resection reconstructed with non-invasive expandable prosthesis. Phenix-Repiphysis was used from 1994 to 2008 followed by Stanmore JTS non-invasive from 2008 to 2016. Survival and complications were recorded. Functional outcomes included Musculoskeletal Tumor Society (MSTS) score, knee range of motion, lower limb discrepancy (LLD). RESULTS Forty children (Sex Ratio = 1) aged a mean 8.8 years (range, 5.6-13.8) at surgery were included in the study. There were 36 osteosarcoma and 4 Ewing sarcoma that involved 33 distal femur and 7 proximal tibia. Cohort (n = 40) consisted of 28 Phenix-Repiphysis and 12 Stanmore with a mean follow-up of 9.8 ± 5.8 years and 6.1 ± 3.1 years, respectively. Postoperative infection rate was 7.5% in the cohort (3 Repiphysis). Functional results were significantly better in the Stanmore group with a mean MSTS of 87.6 ± 5.4% and knee flexion of 112 ± 38°. At last follow-up, implant survival was 100% in Stanmore group, whereas all living Phenix-Repiphysis were explanted. Mechanical failure was the primary cause for revision of Phenix-Repiphysis. Limb length equality was noted in 79% patients with Phenix-Repiphysis and 84% with Stanmore at last follow-up. CONCLUSION Chemotherapy and limb-salvage surgery yield good oncologic outcomes. Expandable endoprostheses are effective in maintaining satisfactory function and lower limb equality. With improvements made in the last generation of "non-invasive" prostheses, implants' survival has been substantially lengthened.
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Zaizi A, Badaoui R, Rabah A, Aboulfateh M, Khmamouch M, Bouabid A, Boussouga M. Enneking type III resection of pubic chondrosarcoma: A case report. Ann Med Surg (Lond) 2022; 74:103270. [PMID: 35145661 PMCID: PMC8802051 DOI: 10.1016/j.amsu.2022.103270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/11/2022] [Accepted: 01/23/2022] [Indexed: 11/26/2022] Open
Abstract
Chondrosarcomas are rare malignant cartilaginous tumor affecting adult and elderly patient. Pelvic and long bones are the most common location. We differentiate conventional chondrosarcoma which arises do novo from preexisting normal bone (primary chondrosarcoma) or within a preexisting lesion such as enchondromas or osteochondromas (secondary chondrosarcoma), Other rare subtypes of chondrosarcoma include clear cell chondrosarcoma, dedifferentiated chondrosarcoma, and mesenchymal chondrosarcoma, which will be considered separately. Although there are diverse clinical presentations depending on the anatomic extend, radiographic features of chondrosarcoma are very characteristic comprising frequently a combination of bone expansion and heterogeneous calcifications. We report a case of a 56-year-old male suffering from fixed mass adhering to the right pubic bone. MRI views showed a lytic lesion of right superior pubic rami, surgical biopsy was in favor of chondrosarcomas, then an en bloc resection was performed following a Pfannenstiel approach without any recurrence after three years of follow-up. Chondrosarcomas are rare bone tumor of adult above the fourth decades. They affect principally pelvis, proximal femur and proximal humerus. Symptoms are essentially pain, rarely palpable mass; However pelvic location can cause gynecological, bowel or bladder problems. Treatment involves radical resection because of chondrosarcomas resistance to chemotherapy and radiotherapy.
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Caetano de Oliveira R, Reith J, Casanova J. Clear Cell Chondrosarcoma with Rib Cage Metastasis: Case Report. Case Rep Oncol 2021; 14:239-243. [PMID: 33776710 PMCID: PMC7983667 DOI: 10.1159/000512067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 10/05/2020] [Indexed: 11/19/2022] Open
Abstract
Clear cell chondrosarcoma is a rare histological subtype of chondrosarcoma, usually with a relatively non-aggressive clinical course. However, infrequently they may relapse and metastasize. We describe a case of a male patient, 53 years old, with rib cage metastases of a clear cell chondrosarcoma 11 years after the first surgical intervention, and review the literature.
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Affiliation(s)
- Rui Caetano de Oliveira
- Pathology Department, Centro Hospitalar e Univeristário de Coimbra, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - John Reith
- Pathology Department, Cleveland Clinic, Cleveland, Ohio, USA
| | - José Casanova
- Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Orthopaedics Department, Centro Hospitalar e Univeristário de Coimbra, Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
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Yin P, Mao N, Liu X, Sun C, Wang S, Chen L, Hong N. Can clinical radiomics nomogram based on 3D multiparametric MRI features and clinical characteristics estimate early recurrence of pelvic chondrosarcoma? J Magn Reson Imaging 2019; 51:435-445. [PMID: 31215096 DOI: 10.1002/jmri.26834] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/28/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Chondrosarcoma (CS) is the second most common primary malignant bone tumor, with a relatively high recurrence rate. However, an effective method that estimates whether pelvic CS will recur after surgery, which influences the formulation of a clinical treatment plan, remains lacking. PURPOSE To develop and validate a clinical radiomics nomograms based on 3D multiparametric magnetic resonance imaging (mpMRI) features and clinical characteristics that could estimate early recurrence (ER) (≤1 year) of pelvic CS. STUDY TYPE Retrospective. POPULATION In all, 103 patients (ER = 41, non-ER = 62) with histologically proven CS were retrospectively analyzed and divided into a training set (n = 72) and a validation set (n = 31). FIELD STRENGTH/SEQUENCE 3.0T axial T1 -weighted (T1 -w), T2 -weighted (T2 -w), diffusion weighted imaging (DWI), contrast-enhanced T1 -weighted (CET1 -w). ASSESSMENT Risk factors (sex, age, type, grade, resection margins, etc.) associated with ER were evaluated. Five individual models based on T1 -w, T2 -w, DWI, CET1 -w, and clinical data were built. Then we compared the performance of models based on T1 -w, T2 -w, CET1 -w and their combination. Lastly, two nomograms based on the best model + clinical data and DWI + clinical data were built. STATISTICAL TESTS The area under the receiver operating characteristic curve (AUC) and accuracy (ACC) were used to evaluate different models. RESULTS Grade was the most important univariate clinical predictor of ER of pelvic CS patients (odds ratio [OR]1 = 4.616, OR2 = 8.939, P < 0.05). T1 -w + T2 -w + CET1 -w had a significantly higher performance than CET1 -w in the training set (P = 0.01). Radiomics features are more important than clinical characteristics in clinical radiomics nomograms, especially for multisequence combined features (OR = 3.208, P < 0.01). Clinical radiomics nomogram based on combined features (T1 -w + T2 -w + CET1 -w) + clinical data achieved an AUC of 0.891 and ACC of 0.857, followed by DWI + clinical data (AUC = 0.882, ACC = 0.760) in the validation set. DATA CONCLUSION The clinical radiomics nomogram had good performance in estimating ER of pelvic CS patients, which would be helpful in clinical decision-making. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:435-445.
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Affiliation(s)
- Ping Yin
- Department of Radiology, Peking University People's Hospital, Beijing, P.R. China
| | - Ning Mao
- Department of Radiology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, Shandong, P.R. China
| | - Xia Liu
- Department of Radiology, Peking University People's Hospital, Beijing, P.R. China
| | - Chao Sun
- Department of Radiology, Peking University People's Hospital, Beijing, P.R. China
| | | | - Lei Chen
- Department of Radiology, Peking University People's Hospital, Beijing, P.R. China
| | - Nan Hong
- Department of Radiology, Peking University People's Hospital, Beijing, P.R. China
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GamalEl Din SF, Abo Sief AF, Fawzy EA, El Fatah MA, Abo Senna WG. Pelvic chondro-sarcoma and erectile dysfunction: A challenging surgical case. Rev Int Androl 2018; 16:34-37. [PMID: 30063021 DOI: 10.1016/j.androl.2017.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 02/16/2017] [Accepted: 02/24/2017] [Indexed: 11/28/2022]
Abstract
A 46 year-old male presented suffering from refractory erectile dysfunction. The patient had a past history of pelvic chondro-sarcoma. This case was a challenge for us; the surgery performed for excision of the sarcoma has resulted in the elimination of both pubic ramia together with excision of part of both corpora and left hemiscrotum. The procedure included a sling application on one side with a mesh sock wrapped around the rear part of the extendor cylinder. Another sling was applied on the contra lateral side without a mesh sock.
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Affiliation(s)
| | | | - Emad Awny Fawzy
- Cairo University, Egypt; Specialist of Andrology & Dermatology, Ministry of Health, Egypt
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Reconstrução com prótese de pedestal no ilíaco e prótese de tumor proximal do fêmur após ressecção ampla de condrossarcoma – resultados de acompanhamento de 10 anos. Rev Bras Ortop 2017. [DOI: 10.1016/j.rbo.2016.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Tang F, Min L, Ye Y, Tang B, Zhou Y, Zhang W, Tu C. Classic Hodgkin lymphoma in pelvis: A case report highlights diagnosis and treatment challenges. Medicine (Baltimore) 2017; 96:e8196. [PMID: 28953683 PMCID: PMC5626326 DOI: 10.1097/md.0000000000008196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Classic Hodgkin lymphoma with pelvic involvement is a rare entity. Diagnosis and treatment for such an uncommon disease are challenging. Here we report a special case of classic Hodgkin lymphoma in pelvis. PATIENT CONCERNS A 20-year-old woman was admitted to our department due to left hip symptoms. The patient reported a history of drenching night sweats, low-grade fever, pruritic rash on the body, and an almost 15% weight loss during the previous 3 months. DIAGNOSES Imaging studies revealed osteolytic destruction of the left hemi-pelvic with a huge soft-tissue mass. Open biopsy established the pathological diagnosis of classic Hodgkin lymphoma. INTERVENTIONS Considering the B symptom, bulky disease, and high risk of pathological fracture of the patient, we performed limb-salvage surgery and 6 cycles ABVD chemotherapy with 2 cycles before surgery. OUTCOMES Up to now, at the 3-year follow-up, there is no sign of disease relapse and metastasis. Besides, her limb function recovered well. LESSONS Based on this case and literature we reviewed, diagnoses for primary bone Hodgkin lymphoma should be cautious. For the treatment, chemotherapy was the main treatment option. Classic Hodgkin lymphoma patients seldom received tumor resection surgery, but for the special bone classic Hodgkin lymphoma individual with a huge tumor volume and high risk of pathological fracture in our study, limb-salvage surgery based on ABVD chemotherapy provided a satisfying clinical outcome.
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Affiliation(s)
- Fan Tang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, MA
| | - Li Min
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, MA
| | - Yunxia Ye
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Tang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Zhou
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Wenli Zhang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Chongqi Tu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
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Reconstruction with iliac pedestal cup and proximal femur tumor prosthesis after wide resection of chondrosarcoma - 10-year follow-up results. Rev Bras Ortop 2016; 52:748-754. [PMID: 29234663 PMCID: PMC5720845 DOI: 10.1016/j.rboe.2016.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 11/21/2016] [Indexed: 11/29/2022] Open
Abstract
Chondrosarcoma is a malignant cartilage-forming neoplasm. It is difficult to treat because of resistance to both chemotherapy and radiation, making wide local excision the only treatment. This report presents an active, 43 year-old man who was diagnosed with recurrent clear cell chondrosarcoma of the proximal left femur, previously reconstructed with a total hip prosthesis, extending to the weight-bearing dome of the acetabulum. Cancer staging study revealed no signs of tumor dissemination at distance. Given the excellent functional status of the patient, the authors performed a Enneking–Dunham type periacetabular pelvic resection and resected en bloc, with the total hip prosthesis including 22 cm of the femur and a portion of the hip abductor apparatus. Acetabular reconstruction was performed with a non-cemented pedestal cup prosthesis fixed at the iliac, and in-femur reconstruction utilized a cemented silver-coated proximal femur modular prosthesis. Today, after a 10-year follow-up, the patient is walking without crutches, he practices recreational cycling without assistance, and he is asymptomatic and free of tumoral disease. At present, no signs of relevant loosening, instability, infection, heterotopic ossification, or any other complications have been observed. Pelvic reconstructions are challenging and risky surgeries; however, the appearance of more functional implants, like the pedestal cup prosthesis, and its correct application and indication, may allow promising clinical and functional results with low complications rate.
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The overexpression of miR-30a affects cell proliferation of chondrosarcoma via targeting Runx2. Tumour Biol 2015; 37:5933-40. [PMID: 26596830 DOI: 10.1007/s13277-015-4454-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 11/17/2015] [Indexed: 12/12/2022] Open
Abstract
MicroRNAs (miRNAs) are emerging as important epigenetic modulators of multiple target genes, leading to abnormal cellular signaling involving cellular proliferation in cancers. Aberrant miRNA expression has been observed in human chondrosarcoma (CS). The purpose of the present study was to evaluate the expression and molecular mechanisms of Runx2 and miR-30a in human CS tissues and CS cell lines JJ012, SW1353, and L3252. In the present study, we found that the expression of miR-30a was markedly downregulated in CS cell lines and human CS tissues, compared to matched non-tumor-associated tissues. Furthermore, miR-30a expression was inversely proportional to that of Runx2 messenger RNA (mRNA) and protein. Upregulation of miR-30a dramatically reduced the proliferation, colony formation, and cell cycle-related proteins of CS cells. Flow cytometry analysis showed that ectopic expression of miR-30a significantly decreased the percentage of S phase cells and increased the percentage of G1/G0 phase cells. Luciferase reporter assays confirmed that miR-30a binding to the 3'-untranslated region (3'-UTR) region of Runx2 inhibited the expression of Runx2 in cancer cells. Taken together, our results suggest that miR-30a plays an important role to inhibit the proliferation of CS cells and presents a novel mechanism for direct miRNA-mediated suppression of Runx2 in CS. Thus, miR-30a/Runx2 may have an important role in treatment of CS patients.
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