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1. Bacci G, Bertoni F, Longhi A, Ferrari S, Forni C, Biagini R, Bacchini P, Donati D, Manfrini M, Bernini G, Lari S: Neoadjuvant chemotherapy for high-grade central osteosarcoma of the extremity. Histologic response to preoperative chemotherapy correlates with histologic subtype of the tumor. Cancer; 2003 Jun 15;97(12):3068-75
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Neoadjuvant chemotherapy for high-grade central osteosarcoma of the extremity. Histologic response to preoperative chemotherapy correlates with histologic subtype of the tumor.
  • BACKGROUND: In primary central high-grade osteosarcoma, a number of distinct subtypes have been identified, but little is known about the response to chemotherapy.
  • METHODS: The authors investigated whether the subtypes correlated with histologic response to chemotherapy in 1058 patients with osteosarcoma of the extremities who were treated with neoadjuvant chemotherapy over the last 20 years.
  • RESULTS: The response to preoperative chemotherapy was good (90% or more tumor necrosis) in 59% of patients and poor (< 90% tumor necrosis) in 41% of patients.
  • CONCLUSIONS: The authors concluded that the histologic subtype of primary central high-grade osteosarcoma of the extremity was strictly correlated with histologic response to chemotherapy and probably, as a consequence, also with prognosis.
  • Further studies are needed to establish whether these results justify a specific therapeutic approach based on the histologic subtype of the tumor.
  • [MeSH-major] Extremities. Osteosarcoma / drug therapy. Osteosarcoma / surgery
  • [MeSH-minor] Adolescent. Antineoplastic Protocols. Chemotherapy, Adjuvant. Female. Humans. Male. Neoadjuvant Therapy. Preoperative Care. Prognosis. Survival Analysis

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  • [Copyright] Copyright 2003 American Cancer Society.
  • (PMID = 12784343.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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2. Ford S, Saithna A, Grimer RJ, Picci P: Comparison of the outcome of conventional osteosarcoma at two specialist international orthopaedic oncology centres. Sarcoma; 2004;8(1):13-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Comparison of the outcome of conventional osteosarcoma at two specialist international orthopaedic oncology centres.
  • OBJECTIVE: To determine the prognostic value of patient and treatment parameters in osteosarcoma, and whether these are equally important across international boundaries.
  • DESIGN: Retrospective, cross-sectional study of 428 patients diagnosed with around-knee osteosarcoma, between 1990 and 1997 in Birmingham, UK, and Bologna, Italy.
  • The most important bad prognostic factors for DFS and OS respectively were raised alkaline phosphatase at diagnosis (P=0.002 and P=0.003), tumour necrosis < 90% following chemotherapy (P=0.001 and P = 0.004) and volume > 150 cm(3) at diagnosis (P=0.04 and P=0.006).
  • A total of 73% of patients at Centre 1 had greater than 90% necrosis of the tumour following neoadjuvant chemotherapy compared with 29% at Centre 2.
  • Chemotherapy effectiveness appears to be a major factor in explaining the survival difference between the two centres.

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  • (PMID = 18521388.001).
  • [ISSN] 1357-714X
  • [Journal-full-title] Sarcoma
  • [ISO-abbreviation] Sarcoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
  • [Other-IDs] NLM/ PMC2395601
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3. Okada K, Hasegawa T, Yokoyama R, Beppu Y, Itoi E: Osteosarcoma with cytokeratin expression: a clinicopathological study of six cases with an emphasis on differential diagnosis from metastatic cancer. J Clin Pathol; 2003 Oct;56(10):742-6
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  • [Title] Osteosarcoma with cytokeratin expression: a clinicopathological study of six cases with an emphasis on differential diagnosis from metastatic cancer.
  • METHODS: Clinicopathological and immunohistochemical features were analysed in 131 patients with non-metastatic, conventional osteosarcoma, treated in Akita University and National Cancer Centre in Tokyo between 1972 and 1999.
  • Three tumours were classified as osteoblastic osteosarcoma, two as fibroblastic, and one as chondroblastic.
  • Surgery with a wide excisional margin was performed in six patients.
  • Preoperative and postoperative chemotherapy was given to five of the six patients, but the effects of these agents were negligible.
  • Three of the six patients developed lung metastases, whereas the other three patients have remained well with no evidence of local recurrence or distant metastasis.
  • CONCLUSIONS: Osteosarcoma with intense immunoreaction for cytokeratin was rare.
  • The clinicopathological features were similar to those of patients with conventional osteosarcoma, except for a higher age, chemotherapy resistance, histological epithelioid features, and pleomorphism.
  • [MeSH-major] Biomarkers, Tumor / analysis. Bone Neoplasms / chemistry. Bone Neoplasms / secondary. Keratins / analysis. Osteosarcoma / chemistry. Osteosarcoma / secondary

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  • (PMID = 14514776.001).
  • [ISSN] 0021-9746
  • [Journal-full-title] Journal of clinical pathology
  • [ISO-abbreviation] J. Clin. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 68238-35-7 / Keratins
  • [Other-IDs] NLM/ PMC1770076
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4. Okada K, Hasegawa T, Yokoyama R, Beppu Y, Itoi E: Prognostic relevance of rosette-like features in osteosarcoma. J Clin Pathol; 2003 Nov;56(11):831-4
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  • [Title] Prognostic relevance of rosette-like features in osteosarcoma.
  • AIMS: To clarify the prognostic relevance of rosette-like features and other clinicopathological and immunohistochemical variables in patients with osteosarcoma.
  • METHODS: Clinicopathological and immunohistochemical variables were analysed in 131 patients with non-metastatic high grade conventional osteosarcoma, with particular attention to the prognostic impact of rosette-like features.
  • In a multivariate analysis, rosette-like features (relative risk (RR), 3.8), a poor chemotherapy effect (RR, 2.9), and a tumour size of 10 cm or more (RR, 2.8) were identified as unfavourable prognostic factors.
  • CONCLUSIONS: Rosette-like features can easily be identified from routine histological slides and the relative risk in patients with non-metastatic, conventional osteosarcoma is as high as other well known prognostic factors, including large size and poor chemotherapy effect.
  • [MeSH-major] Bone Neoplasms / pathology. Osteosarcoma / pathology
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Humans. Multivariate Analysis. Prognosis. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 14600127.001).
  • [ISSN] 0021-9746
  • [Journal-full-title] Journal of clinical pathology
  • [ISO-abbreviation] J. Clin. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1770098
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5. Bacci G, Longhi A, Forni C, Fabbri N, Briccoli A, Barbieri E, Mercuri M, Balladelli A, Ferrari S, Picci P: Neoadjuvant chemotherapy for radioinduced osteosarcoma of the extremity: The Rizzoli experience in 20 cases. Int J Radiat Oncol Biol Phys; 2007 Feb 1;67(2):505-11
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  • [Title] Neoadjuvant chemotherapy for radioinduced osteosarcoma of the extremity: The Rizzoli experience in 20 cases.
  • PURPOSE: Evaluate treatment and outcome of 20 patients with radioinduced osteosarcoma (RIO).
  • Because of previous primary tumor treatment, RIO protocols were different from others we used for non-RIO.
  • PATIENTS AND METHODS: Between 1983 and 1998, we treated 20 RIO patients, ages 4-36 years (mean 16 years), with chemotherapy (two cycles before surgery, three postoperatively).
  • The three postoperative treatments were performed with cycles of MTX/CDP; IFO was used as single agent per cycle repeated three times.
  • RESULTS: Two patients received palliative treatment because their osteosarcoma remained unresectable after preoperative chemotherapy.
  • The remaining 18 patients had surgery (7 amputations, 11 resections); histologic response to preoperative chemotherapy was good in 8 patients, poor in 10.
  • At a mean follow-up of 11 years (range, 7-22 years), 9 patients remained continuously disease-free, 10 died from osteosarcoma and 1 died from a third neoplasm (myeloid acute leukemia).
  • These results are not significantly different from those achieved in 754 patients with conventional osteosarcoma treated in the same period with protocols used for conventional treatment.
  • However, this later group had an 18% 3-year event-free survival after treatment of relapse vs. 0% in the RIO group.
  • CONCLUSION: Treated with neoadjuvant chemotherapy RIO seem to have an outcome that is not significantly different from that of comparable patients with conventional primary high grade osteosarcoma (5-year event-free survival: 40% vs. 60%, p = NS; 5-year overall survival 40% vs. 67%, p < 0.01).
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Neoplasms / drug therapy. Neoplasms, Radiation-Induced / drug therapy. Osteosarcoma / drug therapy
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Child, Preschool. Cisplatin / administration & dosage. Female. Follow-Up Studies. Humans. Ifosfamide / administration & dosage. Male. Methotrexate / administration & dosage. Neoadjuvant Therapy. Retrospective Studies

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  • (PMID = 17118571.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; YL5FZ2Y5U1 / Methotrexate
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6. Lewis VO, Raymond K, Mirza AN, Lin P, Yasko AW: Outcome of postradiation osteosarcoma does not correlate with chemotherapy response. Clin Orthop Relat Res; 2006 Sep;450:60-6
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  • [Title] Outcome of postradiation osteosarcoma does not correlate with chemotherapy response.
  • Postradiation osteosarcoma is a rare tumor with a historically poor prognosis.
  • We ascertained the long-term outcome of patients with this disease treated in the era of contemporary chemotherapy.
  • Twenty-seven patients diagnosed with postradiation osteosarcoma and treated with chemotherapy and surgical resection from 1980-2003 were identified.
  • Demographics, anatomic location, stage, chemo- therapy, necrosis rate, recurrence and metastatic rates were recorded; Kaplan-Meier survival rates were estimated.
  • Twenty-two patients received induction chemotherapy for a mean of four cycles (range, 2-6 cycles).
  • Histologic response to chemotherapy did not correlate with survival.
  • Unlike conventional osteosarcoma, response to chemotherapy (necrosis) did not have prognostic significance.
  • Current chemotherapy regimens fail to impact survival in postradiation osteosarcoma.
  • LEVEL OF EVIDENCE: Therapeutic study, level IV (retrospective comparative study).
  • [MeSH-major] Bone Neoplasms / drug therapy. Bone Neoplasms / mortality. Neoplasms, Radiation-Induced / drug therapy. Neoplasms, Radiation-Induced / mortality. Osteosarcoma / drug therapy. Osteosarcoma / mortality
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Child. Disease-Free Survival. Female. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Survival Analysis

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  • (PMID = 16906104.001).
  • [ISSN] 0009-921X
  • [Journal-full-title] Clinical orthopaedics and related research
  • [ISO-abbreviation] Clin. Orthop. Relat. Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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7. Bacci G, Ferrari S, Ruggieri P, Biagini R, Fabbri N, Campanacci L, Bacchini P, Longhi A, Forni C, Bertoni F: Telangiectatic osteosarcoma of the extremity: neoadjuvant chemotherapy in 24 cases. Acta Orthop Scand; 2001 Apr;72(2):167-72
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  • [Title] Telangiectatic osteosarcoma of the extremity: neoadjuvant chemotherapy in 24 cases.
  • Between April 1990 and December 1994, we treated 24 patients with telangiectatic osteosarcoma (TO) of the extremities with neoadjuvant chemotherapy using 2 protocols.
  • The histologic response to chemotherapy was good (90% or more tumor necrosis) in 23 patients, of whom 12 had total necrosis.
  • With a mean follow-up of 74 (60-96) months, 20 patients remained continuously free of disease and 4 relapsed with lung metastases.
  • Comparing these results to the ones achieved in 269 contemporary patients with conventional osteosarcoma of the extremities using the same protocols for chemotherapy, we found a significantly better histologic response to chemotherapy (96% vs 68% of good histologic response; p = 0.004) and disease-free survival (83% vs 55%; p = 0.01) in the TO group.
  • We conclude that TO, once considered a lethal tumor, seems to be even more sensitive to chemotherapy than conventional osteosarcoma, and that most of these patients may be cured without amputation.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Neoplasms / drug therapy. Bone Neoplasms / pathology. Neoadjuvant Therapy. Osteosarcoma / drug therapy. Osteosarcoma / pathology. Telangiectasis
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Female. Follow-Up Studies. Humans. Male. Treatment Outcome

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  • (PMID = 11372948.001).
  • [ISSN] 0001-6470
  • [Journal-full-title] Acta orthopaedica Scandinavica
  • [ISO-abbreviation] Acta Orthop Scand
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Norway
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8. Kreuter M, Bieker R, Bielack SS, Auras T, Buerger H, Gosheger G, Jurgens H, Berdel WE, Mesters RM: Prognostic relevance of increased angiogenesis in osteosarcoma. Clin Cancer Res; 2004 Dec 15;10(24):8531-7
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  • [Title] Prognostic relevance of increased angiogenesis in osteosarcoma.
  • PURPOSE: The purpose of this work was to evaluate the prognostic relevance of microvessel density (MVD) for response to chemotherapy and long-term outcome in osteosarcoma.
  • EXPERIMENTAL DESIGN: Pretherapeutic tumor biopsies of 60 patients with high-grade central osteosarcoma, who were treated according to multimodal neoadjuvant protocols of the German-Austrian-Swiss Cooperative Osteosarcoma Study Group, were evaluated for intratumoral MVD.
  • At a median follow-up period of 3.5 years, patients with a high (>median) MVD had significantly higher 5- and 10-year overall survival rates (84%) than patients with low (< or =median) MVD (49%; P = 0.0029).
  • In a subgroup analysis of 44 patients with primary high-grade central osteosarcoma of the extremities without primary metastases and good surgical remission, high MVD was associated with 5- and 10-year overall survival rates of 91% compared with 58% for low MVD (P = 0.034).
  • A good response to chemotherapy (histologic grading scale of Salzer-Kuntschik) correlated significantly with a high MVD (P = 0.006).
  • CONCLUSIONS: Increased angiogenesis is a prognostic indicator for higher survival and response rates to chemotherapy in patients with osteosarcoma.
  • Thus, measurement of MVD might be useful in decisions selecting patients for future neoadjuvant treatment.
  • [MeSH-major] Bone Neoplasms / blood supply. Neovascularization, Pathologic / metabolism. Osteosarcoma / blood supply
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Extremities. Female. Humans. Leg Bones. Male. Microcirculation. Middle Aged. Neoadjuvant Therapy. Prognosis. Retrospective Studies. Survival Rate

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  • (PMID = 15623635.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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9. Yang SH, Wu CT, Wang CJ, Kuo MS, Yang RS: Intracortical osteosarcoma: report of a case. J Formos Med Assoc; 2000 Sep;99(9):721-5
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  • [Title] Intracortical osteosarcoma: report of a case.
  • Intracortical osteosarcoma is the rarest anatomic variation of osteosarcoma.
  • We present a case of osteosarcoma in an 18-year-old Taiwanese man that originated within the cortex of the tibial diaphysis.
  • Histopathologic examination of the biopsy specimen showed an osteoblastic osteosarcoma mingled with some fibroblastic foci.
  • Adjuvant chemotherapy was administered before and after the operation.
  • A review of all reported cases of intracortical osteosarcoma revealed that the initial method of treatment plays an important role in local recurrence and distant metastasis.
  • The outcomes of more recently reported cases have improved because of early awareness of the possibility of malignancy and advances in chemotherapy.
  • However, whether patients with intracortical osteosarcoma have a different prognosis from those with conventional osteosarcoma cannot be determined, because of the small number of intracortical osteosarcoma cases available for analysis.

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  • (PMID = 11000737.001).
  • [ISSN] 0929-6646
  • [Journal-full-title] Journal of the Formosan Medical Association = Taiwan yi zhi
  • [ISO-abbreviation] J. Formos. Med. Assoc.
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Singapore
  • [Number-of-references] 18
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10. Kenan S, Ginat DT, Steiner GC: Dedifferentiated high-grade osteosarcoma originating from low-grade central osteosarcoma of the fibula. Skeletal Radiol; 2007 Apr;36(4):347-51
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  • [Title] Dedifferentiated high-grade osteosarcoma originating from low-grade central osteosarcoma of the fibula.
  • Low grade central osteosarcoma is a distinct, rare low grade malignant neoplasm characterized histologically by a spindle cell proliferation associated with trabecular bone formation.
  • However, it has the potential to recur, dedifferentiate, and metastasize subsequent to surgical treatment.
  • Initial biopsy demonstrated a high-grade osteosarcoma.
  • Following biopsy the patient received 3 months of chemotherapy at a different institution.
  • X-rays indicated a very aggressive tumor in the diaphysis of the proximal fibula, MRI revealed soft tissue involvement.
  • The tumor and surrounding soft-tissues were excised en bloc at our institution.
  • Microscopically, the lesion consisted of high-grade osteosarcoma as well as an underlying LGCOS that involved the cortex and medullary cavity of the fibula.
  • No chemotherapy effect was appreciated histologically or clinically.
  • [MeSH-major] Bone Neoplasms / diagnosis. Fibula / pathology. Lung Neoplasms / secondary. Osteosarcoma / diagnosis. Soft Tissue Neoplasms / diagnosis


11. Hauben EI, Weeden S, Pringle J, Van Marck EA, Hogendoorn PC: Does the histological subtype of high-grade central osteosarcoma influence the response to treatment with chemotherapy and does it affect overall survival? A study on 570 patients of two consecutive trials of the European Osteosarcoma Intergroup. Eur J Cancer; 2002 Jun;38(9):1218-25
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  • [Title] Does the histological subtype of high-grade central osteosarcoma influence the response to treatment with chemotherapy and does it affect overall survival? A study on 570 patients of two consecutive trials of the European Osteosarcoma Intergroup.
  • Large randomised trials are mandatory when one wants to examine the effects of different aspects (such as the treatment modality) of a pathological condition on the overall outcome.
  • This is especially true when studying a disease in which there is a multifactorial influence on progression and outcome such as osteosarcoma.
  • Data on 570 patients with biopsy-proven primary central osteosarcoma of an extremity included in two consecutive studies of the European Osteosarcoma Intergroup (EOI) were analysed in order to evaluate if the histological subtype of the biopsy specimen correlated with the subtype of osteosarcoma represented in the resected specimen, if there was a relationship between the histological subtype and overall survival and if there was a relationship between the histological subtype and histological response to chemotherapy.
  • High-grade osteosarcoma, as defined by established criteria, was subtyped as either conventional, chondroblastic, teleangiectatic, small cell, fibroblastic, osteoclast rich, anaplastic and sclerotic/osteoblastic well differentiated.
  • A panel of experienced pathologists with a special interest in bone pathology was appointed to review the histological diagnosis and to assess the tumour response to chemotherapy on the resected specimen of each patient entered into the trials.
  • Of the 568 patients for whom subtype was available, 404 (71%) were of the conventional type, 54 (10%) were chondroblastic, 53 (9%) had fibroblastic tumours and the remainder consisted of rare subtypes.
  • A good response to preoperative chemotherapy was defined as 90% or more necrosis.
  • The proportion of patients responding well to chemotherapy differed significantly between subtypes (Chi-square test statistics=11.44, P=0.01 on 3 degrees of freedom (d.f.)).
  • In comparison with the conventional subtype, there was a higher proportion of good responders in the fibroblastic group and a lower proportion of good responders in the chondroblastic group.
  • Good responders had a significantly better survival than patients who responded poorly to the pre-operative chemotherapy (logrank statistic=25.20, P<0.01 on 1 df).
  • However, despite this large multi-institutional study, we have insufficient numbers of non-conventional tumours to examine this unambiguously for these subsets.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Neoplasms / pathology. Osteosarcoma / pathology
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Cisplatin / administration & dosage. Doxorubicin / administration & dosage. Humans. Infant. Infant, Newborn. Methotrexate / administration & dosage. Risk Factors. Survival Analysis. Treatment Outcome

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  • [CommentIn] Eur J Cancer. 2003 Mar;39(4):548-9 [12751388.001]
  • (PMID = 12044509.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate
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12. Goldstein-Jackson SY, Gosheger G, Delling G, Berdel WE, Exner GU, Jundt G, Machatschek JN, Zoubek A, Jürgens H, Bielack SS, Cooperative Osteosarcoma Study Group COSS: Extraskeletal osteosarcoma has a favourable prognosis when treated like conventional osteosarcoma. J Cancer Res Clin Oncol; 2005 Aug;131(8):520-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Extraskeletal osteosarcoma has a favourable prognosis when treated like conventional osteosarcoma.
  • PURPOSE: The aims of this analysis were to investigate the clinical features of extraskeletal osteosarcoma (ESOS) and examine the outcome after multi-modal therapy.
  • METHODS: The co-operative osteosarcoma study-group database was searched for patients with extraskeletal osteosarcoma.
  • Eligible patients were included in a retrospective analysis of patient, tumour and treatment related variables and outcome.
  • As for conventional osteosarcoma, scheduled treatment included surgery and multi-agent chemotherapy.
  • RESULTS: Seventeen eligible patients were identified with a median age of 44 years (range, 3-65 years).
  • This may be due to the combination of multi-agent chemotherapy with surgery, and we recommend this approach in the treatment of ESOS.
  • [MeSH-major] Osteosarcoma / diagnosis. Osteosarcoma / therapy
  • [MeSH-minor] Adolescent. Adult. Bone Neoplasms / diagnosis. Bone Neoplasms / therapy. Chemotherapy, Adjuvant. Child. Child, Preschool. Disease-Free Survival. Female. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Survival Analysis

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  • (PMID = 15918046.001).
  • [ISSN] 0171-5216
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
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13. Mohseny AB, Tieken C, van der Velden PA, Szuhai K, de Andrea C, Hogendoorn PC, Cleton-Jansen AM: Small deletions but not methylation underlie CDKN2A/p16 loss of expression in conventional osteosarcoma. Genes Chromosomes Cancer; 2010 Dec;49(12):1095-103
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  • [Title] Small deletions but not methylation underlie CDKN2A/p16 loss of expression in conventional osteosarcoma.
  • Conventional osteosarcoma is characterized by rapid growth, high local aggressiveness, and metastasizing potential.
  • Patients developing lung metastases experience poor prognosis despite extensive chemotherapy regimens and surgical interventions.
  • Previously we identified a subgroup of osteosarcoma patients with loss of CDKN2A/p16 protein expression in the primary tumor biopsies which was significantly predictive of a very poor prognosis.
  • Here we aimed to identify the underlying mechanism(s) of this protein loss in relation to osteosarcoma behavior.
  • The CDKN2A locus was analyzed in osteosarcoma cases with total loss of CDKN2A/p16 expression and in cases with high protein expression using melting curve analysis-methylation assay (MCA-Meth), fluorescent in situ hybridization (FISH), multiplex ligation-dependent probe amplification (MLPA), and mutation analysis.
  • Genomic loss of CDKN2A instead of promoter methylation might be a plausible explanation for the rapid proliferation and high aggressiveness of osteosarcoma by simultaneous impairment CDKN2A/p14(ARF) function.
  • [MeSH-major] Bone Neoplasms / genetics. Cyclin-Dependent Kinase Inhibitor p16 / metabolism. Gene Expression. Genes, p16. Osteosarcoma / genetics. Sequence Deletion

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  • [Copyright] © 2010 Wiley-Liss, Inc.
  • (PMID = 20737480.001).
  • [ISSN] 1098-2264
  • [Journal-full-title] Genes, chromosomes & cancer
  • [ISO-abbreviation] Genes Chromosomes Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / DNA, Neoplasm
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14. Punyaratabandhu T, Wittayawongsaruji S, Rajchadara S, Thanakit V, Charoenvareekul S, Khunkitti N, Songpatanasilp T: The correlation of Tc-99m MIBI scintigraphy and histological response in determining the percentage of tumor necrosis in osteosarcoma after preoperative chemotherapy. J Med Assoc Thai; 2005 Nov;88 Suppl 3:S53-62
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  • [Title] The correlation of Tc-99m MIBI scintigraphy and histological response in determining the percentage of tumor necrosis in osteosarcoma after preoperative chemotherapy.
  • PURPOSE: The most important prognostic factor of osteosarcoma is the percentage of tumor necrosis.
  • MATERIAL AND METHOD: During September 2002 to August 2004, nine consecutive patients with the diagnosis of conventional osteosarcoma were included in the present study.
  • The osteosarcoma protocol comprises 3 courses of doxorubicin and cisplatin preoperatively followed by wide resection of tumors and another 3 courses of postoperative chemotherapy.
  • The Tc-99m MIBI scintigraphy examination was carried out before commencing chemotherapy and after completing preoperative chemotherapy.
  • Comparison of TBR before and after preoperative chemotherapy was used to calculate the alteration ratio which was reported in terms of percentage.
  • The histological assessment of the response to chemotherapy was performed using the standard technique according to the current practice of osteosarcoma from the Mayo Clinic.
  • This technique can be used to predict the response of osteosarcoma after preoperative chemotherapy.
  • [MeSH-major] Bone Neoplasms / pathology. Bone Neoplasms / radionuclide imaging. Osteosarcoma / pathology. Osteosarcoma / radionuclide imaging
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Agents / therapeutic use. Child. Female. Humans. Male. Middle Aged. Necrosis / chemically induced. Necrosis / pathology. Necrosis / radionuclide imaging. Prospective Studies. Radiopharmaceuticals. Technetium Tc 99m Sestamibi

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  • (PMID = 16862675.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Thailand
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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15. Kreuter M, Bieker R, Bielack SS, Auras T, Buerger H, Gosheger G, Jurgens H, Berdel WE, Mesters RM: Prognostic relevance of increased angiogenesis in osteosarcoma. J Clin Oncol; 2004 Jul 15;22(14_suppl):9022

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic relevance of increased angiogenesis in osteosarcoma.
  • : 9022 Background: Osteosarcoma, the most frequent primary malignant bone tumor is a chemotherapy-sensitive tumor with survival rates reaching 50 to 80 %.
  • However, the role of angiogenesis in osteosarcoma still remains unclear.
  • METHODS: Pretherapeutic tumor biopsies of 60 patients with high grade central osteosarcoma, who were treated according to multimodal neoadjuvant protocols of the Cooperative German-Austrian-Swiss Osteosarcoma Study Group, were evaluated for intratumoral microvessel density.
  • At a median follow up period of 1274 days patients with a high (≥ 53) MVD had significantly better 5- and 10-year overall survival rates with 84 % than patients with low (≤ 52) MVD with 49 % (p = 0.0029, Cox regression analysis).
  • In a subgroup analysis of 47 patients with primary high grade central osteosarcoma of the extremities without primary metastases, patients with high MVD showed significant better 5- and 10-year overall survival rates with 91 % versus 61 % for low MVD (p = 0,039).
  • A good response to chemotherapy (histological grading scale of Salzer-Kuntschik) correlated significantly with a high degree of MVD (r = 0.3; p = 0.033).
  • CONCLUSIONS: Increased angiogenesis is a prognostic indicator for better survival and response to chemotherapy in patients with osteosarcoma.
  • Thus, determination of MVD might be useful in selecting patients for further neoadjuvant treatment decisions.

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  • (PMID = 28013660.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Tan ML, Choong PF, Dass CR: Osteosarcoma: Conventional treatment vs. gene therapy. Cancer Biol Ther; 2009 Jan;8(2):106-17
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  • [Title] Osteosarcoma: Conventional treatment vs. gene therapy.
  • Osteosarcoma (OS) remains the most common primary malignant bone cancer affecting children and adolescents.
  • Majority of patients are subjected to surgery and chemotherapy with limited alternatives to consider.
  • However, with increasing knowledge of the molecular pathogenesis of OS, advancements in OS therapy research fields have developed potential agents for a more targeted and localised approach to treatment.
  • Thus, this review attempts to examine some common treatment strategies (surgery, radiotherapy and chemotherapy) employed clinically as well as recent developments in newer experimental therapy methods (gene therapy) which might potentially benefit patients.
  • [MeSH-major] Bone Neoplasms / drug therapy. Bone Neoplasms / therapy. Genetic Therapy. Osteosarcoma / drug therapy. Osteosarcoma / therapy
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Humans. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 19098456.001).
  • [ISSN] 1555-8576
  • [Journal-full-title] Cancer biology & therapy
  • [ISO-abbreviation] Cancer Biol. Ther.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 155
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17. Lewis IJ, Nooij MA, Whelan J, Sydes MR, Grimer R, Hogendoorn PC, Memon MA, Weeden S, Uscinska BM, van Glabbeke M, Kirkpatrick A, Hauben EI, Craft AW, Taminiau AH, MRC BO06 and EORTC 80931 collaborators, European Osteosarcoma Intergroup: Improvement in histologic response but not survival in osteosarcoma patients treated with intensified chemotherapy: a randomized phase III trial of the European Osteosarcoma Intergroup. J Natl Cancer Inst; 2007 Jan 17;99(2):112-28
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  • [Title] Improvement in histologic response but not survival in osteosarcoma patients treated with intensified chemotherapy: a randomized phase III trial of the European Osteosarcoma Intergroup.
  • BACKGROUND: Previous randomized controlled trials that used the two-drug chemotherapy regimen of cisplatin and doxorubicin as the conventional arm showed no evidence of benefit from an increase in the number of agents or the length of treatment.
  • METHODS: Previously untreated patients with nonmetastatic, high-grade, central osteosarcoma of an extremity were randomly assigned to Regimen-C (conventional treatment with six 3-week cycles of cisplatin [100 mg/m2 by 24-hour infusion] and doxorubicin [25 mg/m2/day by 4-hour infusion for 3 days]) or to Regimen-DI (intensified treatment with identical total doses of cisplatin and doxorubicin, planned as six 2-week cycles supported by granulocyte colony stimulating factor (G-CSF).
  • RESULTS: Between May 1993 and September 2002, treatment was randomly allocated to 497 eligible patients.
  • Six cycles of chemotherapy were completed by 78% of patients in Regimen-C and 80% of patients in Regimen-DI.
  • The delivered preoperative median dose intensity of cisplatin was 86% in Regimen-C and 111% in Regimen-DI (as the percentage of that planned for the conventional regimen).
  • CONCLUSIONS: Planned intensification of chemotherapy with cisplatin and doxorubicin increased received dose intensity and resulted in a statistically significant increase in favorable histologic response rate, but not in increased progression-free or overall survival.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Bone Neoplasms / mortality. Bone Neoplasms / pathology. Osteosarcoma / mortality. Osteosarcoma / pathology
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Disease-Free Survival. Dose-Response Relationship, Drug. Doxorubicin / administration & dosage. Drug Administration Schedule. Europe / epidemiology. Female. Humans. Kaplan-Meier Estimate. Leukopenia / chemically induced. Male. Neutropenia / chemically induced. Odds Ratio. Research Design. Survival Analysis. Thrombocytopenia / chemically induced. Treatment Outcome


18. Goto T, Okuma T, Nakada I, Hozumi T, Kondo T: [Preoperative adjuvant therapy for primary malignant bone tumors]. Gan To Kagaku Ryoho; 2007 Nov;34(11):1750-4
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  • [Title] [Preoperative adjuvant therapy for primary malignant bone tumors].
  • In primary bone sarcomas, the efficacy of chemotherapy varies according to the histological types.
  • Prognoses are poor in patients with osteosarcoma or Ewing's sarcoma, when surgery alone is performed.
  • However, because these sarcomas are chemosensitive, their prognoses have been improved with adjuvant chemotherapy.
  • Nowadays, in highgrade bone sarcomas, especially in osteosarcoma, Ewing.s sarcoma and malignant fibrous histiocytoma of bone, adjuvant chemotherapy including neoadjuvant or preoperative chemotherapy is usually performed.
  • The purpose of the neoadjuvant chemotherapy is (I) to prevent distant metastases, (II) to reduce the size of the primary tumor and (III) to evaluate the efficacy of the chemotherapeutic agents.
  • Evaluating the efficacy of the chemotherapeutic agents in preoperative chemotherapy facilitates rational selection of postoperative chemotherapeutic agents.
  • Commonly used drugs include adriamycin, ifosfamide, cisplatin, methotrexate and vincristine in osteosarcoma, and vincristine, adriamycin, cyclophosphamide, ifosfamide, actinomycin-D and etoposide in Ewing's sarcoma.
  • In contrast, chondrosarcomas are chemoresistant, and chemotherapy is rarely performed.
  • Low-grade bone sarcomas, e. g., parosteal osteosarcoma, central low-grade osteosarcoma, are well cured only by surgical excision, and adjuvant chemotherapy is not performed for these low-grade sarcomas.
  • To enhance the efficacy of preoperative chemotherapy, various modalities have been used e. g., intraarterial infusion, caffeine-assisted chemotherapy, and local perfusion with hyperthermia.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Neoplasms / drug therapy
  • [MeSH-minor] Cyclophosphamide / administration & dosage. Dactinomycin / administration & dosage. Doxorubicin / administration & dosage. Drug Administration Schedule. Humans. Ifosfamide / administration & dosage. Neoadjuvant Therapy. Neoplasm Metastasis / prevention & control. Osteosarcoma / drug therapy. Osteosarcoma / surgery. Prognosis. Sarcoma, Ewing / drug therapy. Sarcoma, Ewing / surgery. Soft Tissue Neoplasms / drug therapy. Soft Tissue Neoplasms / surgery. Vincristine / administration & dosage

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  • (PMID = 18030009.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; UM20QQM95Y / Ifosfamide; VAC protocol; VACA protocol; VAIA protocol
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19. Daecke W, Bielack S, Martini AK, Ewerbeck V, Jürgens H, Kotz R, Winkelmann W, Kabisch H, Kevric M, Bernd L: Osteosarcoma of the hand and forearm: experience of the Cooperative Osteosarcoma Study Group. Ann Surg Oncol; 2005 Apr;12(4):322-31
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  • [Title] Osteosarcoma of the hand and forearm: experience of the Cooperative Osteosarcoma Study Group.
  • BACKGROUND: Osteosarcoma is extremely rare in the hand and forearm.
  • Therefore, only limited data are available for planning treatment or predicting the outcome and prognosis of osteosarcoma in the peripheral upper extremity.
  • METHODS: Epidemiological, clinical, and histopathologic data were analyzed in 39 patients with osteosarcoma of the forearm or hand who were enrolled in studies of the Cooperative German-Austrian-Swiss Osteosarcoma Study Group from 1977 to December 2000.
  • In patients with high-grade osteosarcoma, the treatment entailed surgical resection in combination with chemotherapy, whereas patients with low-grade osteosarcoma underwent only surgery.
  • RESULTS: The 5-year overall survival rate among the 33 patients with high-grade central osteosarcoma of the distal upper extremity was 86.2% +/- 6.4%.
  • Five of the eight patients with secondary metastases were in remission at the time of analysis.
  • Four patients died of their disease, and two patients died of chemotherapy-related complications.
  • All six patients whose osteosarcoma was not classified as high-grade central osteosarcoma were in remission at the time of analysis.
  • CONCLUSIONS: The results demonstrate a remarkably high survival rate for patients with high-grade osteosarcoma of the hand and forearm and confirm that multiagent chemotherapy in combination with wide excision is a highly effective treatment for this malignant tumor.
  • [MeSH-major] Bone Neoplasms. Bones of Upper Extremity. Osteosarcoma
  • [MeSH-minor] Adolescent. Adult. Amputation. Antineoplastic Combined Chemotherapy Protocols. Bone Transplantation. Child. Child, Preschool. Disease-Free Survival. Female. Forearm. Germany / epidemiology. Hand. Humans. Male. Middle Aged. Survival Rate

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  • (PMID = 15827675.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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20. Asai T, Myoui A, Fujimoto T, Hara J, Aozasa K, Yoshikawa H: Osteosarcoma after bone marrow transplantation for acute lymphoblastic leukemia. Int J Clin Oncol; 2002 Oct;7(5):318-21
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  • [Title] Osteosarcoma after bone marrow transplantation for acute lymphoblastic leukemia.
  • A male patient initially diagnosed with acute lymphoblastic leukemia at age 9 years received chemotherapy (total body irradiation, 12 Gy) followed by allogeneic bone marrow transplantation.
  • Radiological and histological examinations led to a diagnosis of conventional osteosarcoma.
  • We performed intensive chemotherapy and wide local excision of the osteosarcoma.
  • Intensive chemotherapy was accomplished as planned, although recovery from myelosuppression was delayed during some cycles.
  • This is an extremely rare case of osteosarcoma after bone marrow transplantation.
  • [MeSH-major] Bone Marrow Transplantation / adverse effects. Bone Neoplasms / etiology. Neoplasms, Second Primary / etiology. Osteosarcoma / etiology. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy


21. Grimer RJ, Cannon SR, Taminiau AM, Bielack S, Kempf-Bielack B, Windhager R, Dominkus M, Saeter G, Bauer H, Meller I, Szendroi M, Folleras G, San-Julian M, van der Eijken J: Osteosarcoma over the age of forty. Eur J Cancer; 2003 Jan;39(2):157-63
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  • [Title] Osteosarcoma over the age of forty.
  • The European Musculo Skeletal Oncology Society (EMSOS) has carried out a retrospective review of patients over the age of 40 years with osteosarcoma.
  • 42 patients had osteosarcoma arising in Paget's disease, median survival was 9 months.
  • Patients with axial or metastatic tumours also did badly whilst 41 patients with radiation-induced osteosarcoma had a prognosis paralleling conventional osteosarcoma matched for patient age and site of the tumour.
  • 238 patients had high grade non-metastatic osteosarcoma and had a survival of 46% at 5 years.
  • Older patients had less chemotherapy and fared worse.
  • Osteosarcoma in the elderly is a curable condition and warrants intensive treatment with chemotherapy and surgical resection.
  • [MeSH-major] Bone Neoplasms / mortality. Osteosarcoma / mortality
  • [MeSH-minor] Adult. Age Distribution. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasms, Radiation-Induced / mortality. Neoplasms, Radiation-Induced / therapy. Osteitis Deformans / mortality. Osteitis Deformans / therapy. Prognosis. Retrospective Studies. Sex Distribution. Survival Analysis

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  • (PMID = 12509946.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] England
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22. Ambroszkiewicz J, Gajewska J, Klepacka T, Bilska K, Woźniak W, Laskowska-Klita T: [Biochemical bone turnover markers in patients with conventional and nonconventional osteosarcoma]. Pol Merkur Lekarski; 2006 Oct;21(124):330-4
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  • [Title] [Biochemical bone turnover markers in patients with conventional and nonconventional osteosarcoma].
  • They are considered to be useful in diagnosis and treatment of many metastatic bone diseases and primary osseous tumours.
  • THE AIM: of the study was to assess bone turnover markers in patients with conventional and nonconventional osteosarcoma during treatment.
  • MATERIAL AND METHODS: We examined 55 patients (5-20 years) with osteosarcoma.
  • Among them 91% had conventional and 9% had nonconventional histology.
  • Among patients with most frequent conventional osteosarcoma distinguished histological subtypes.
  • Bone turnover markers were determined in serum by immunoenzymatic assay at diagnosis, during preoperative- and postoperative chemotherapy and then after treatment.
  • RESULTS: We found different values of bone turnover markers in serum of patients with conventional osteosarcoma.
  • The highest activity of bone alkaline phosphatase and collagen type I crosslinked C-telopeptide in children with osteoblastic subtype of osteosarcoma were obtained.
  • The levels of tested parameters decreased about 20-40% during preoperative and postoperative chemotherapy, then they increased after treatment first of all in patients with chondroblastic subtype (p < 0.05).
  • Next we found that the osteocalcin concentration was 4-fold lower, in nonconventional osteosarcoma in comparison to the conventional.
  • This marker is stable during treatment and remains unchanged after it.
  • Moreover we showed that the changes of the bone alkaline phosphatase activity and the collagen type I crosslinked C-telopeptide concentration during and after treatment were less dynamic in children with nonconventional osteosarcoma.
  • CONCLUSIONS: Observed changes of markers in various histological subtypes of osteosarcoma can indicate different rate of their bone turnover.
  • Changes observed during treatment are more dynamic in conventional than in nonconventional type of osteosarcoma.
  • [MeSH-major] Alkaline Phosphatase / blood. Biomarkers, Tumor / blood. Bone Neoplasms / blood. Bone Resorption / metabolism. Collagen Type I / blood. Osteocalcin / blood. Osteosarcoma / blood

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  • (PMID = 17205770.001).
  • [ISSN] 1426-9686
  • [Journal-full-title] Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
  • [ISO-abbreviation] Pol. Merkur. Lekarski
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Collagen Type I; 0 / Peptides; 0 / collagen type I trimeric cross-linked peptide; 104982-03-8 / Osteocalcin; EC 3.1.3.1 / Alkaline Phosphatase
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23. Chow LT, Kumta SM: Primary osteochondrorhabdomyosarcoma (malignant mesenchymoma) of the fibula: a rare tumour in an unusual site -- case report and review of the literature. APMIS; 2004 Sep;112(9):617-23
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  • Malignant mesenchymoma, defined by Stout as sarcomas comprising two or more unrelated differentiated tissue elements other than a fibrosarcoma component, is rare.
  • Including our present patient, 16 cases of primary malignant mesenchymoma of bone are found in the English literature, affecting mainly adolescents and young adults, with a slight male predominance and predilection for the metaphysis of long bones, especially around the knee.
  • The clinical features of primary malignant mesenchymoma of bone thus resemble those of conventional osteosarcoma.
  • Moreover, our case illustrates that, with combination chemotherapy targeted for individual elements, the prognosis of this rare tumour might be much improved, as in osteosarcoma.
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy. Child. Female. Humans. Immunohistochemistry

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  • (PMID = 15601312.001).
  • [ISSN] 0903-4641
  • [Journal-full-title] APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
  • [ISO-abbreviation] APMIS
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Denmark
  • [Number-of-references] 22
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24. Bernd L, Saleh H, Zahlten-Hinguranage A, Zeifang F: [Parosteal osteosarcoma (POS). Clinical and therapeutic aspects]. Orthopade; 2002 Nov;31(11):1067-75
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  • [Title] [Parosteal osteosarcoma (POS). Clinical and therapeutic aspects].
  • Parosteal osteosarcoma is a malignant bone-forming tumor, which is characterized by its superficial origin and its high structural differentiation.
  • Because of the radiological and histological variability, finding the right diagnosis is a great challenge for physicians, radiologists, and pathologists, especially at the time of primary manifestation.
  • Wide resection with sufficient margin is the adequate therapy.
  • High-grade parosteal osteosarcoma needs adjuvant chemotherapy.
  • Our own experience with secondary dedifferentiation and the possibility of primary undergrading shows that regarding diagnostics, operative therapy, and follow-up parosteal osteosarcoma should be treated like conventional osteosarcoma.
  • [MeSH-major] Bone Neoplasms. Femoral Neoplasms. Humerus. Osteosarcoma, Juxtacortical. Tibia
  • [MeSH-minor] Adolescent. Adult. Bone Transplantation. Female. Follow-Up Studies. Fracture Fixation, Internal. Humans. Male. Middle Aged. Prostheses and Implants. Time Factors

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  • (PMID = 12436325.001).
  • [ISSN] 0085-4530
  • [Journal-full-title] Der Orthopäde
  • [ISO-abbreviation] Orthopade
  • [Language] ger
  • [Publication-type] Case Reports; Comparative Study; English Abstract; Journal Article
  • [Publication-country] Germany
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25. Amanatullah DF, Ngann KK, Borys D, Tamurian RM: Progression of aggressive metastatic carcinosarcoma after treatment of epithelioid osteosarcoma. Orthopedics; 2010 Jun;33(6):445
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  • [Title] 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 5.7% of all osteosarcomas and portends an extremely poor prognosis.
  • The 5-year survival rate for patients with epithelioid osteosarcoma treated with surgery (with or without chemotherapy) is 13.5%.
  • This is in direct contrast to the >70% ten-year survival rate of conventional osteosarcoma treated with surgery and chemotherapy.
  • This article presents a fatal case of epithelioid osteosarcoma in an 11-year-old girl with right knee pain of 6 months' duration.
  • Biopsy demonstrated morphologic findings consistent with high-grade osteosarcoma with epithelioid features.
  • In this case, the epithelioid cells failed to respond to conventional or subsequent experimental chemotherapy for osteosarcoma and eventual metastasized to the lymph nodes and lungs despite multiple ablative surgeries.
  • The epithelial component was more aggressive than the cells of mesenchymal origin, highlighting the need for continued research and a more favorable outcome for this rare subset of osteosarcoma.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Bone Neoplasms / therapy. Carcinosarcoma / chemically induced. Osteosarcoma / therapy. Tibia
  • [MeSH-minor] Biopsy. Chemotherapy, Adjuvant / adverse effects. Child. Diagnosis, Differential. Disease Progression. Fatal Outcome. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Tomography, X-Ray Computed

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  • [Copyright] Copyright 2010, SLACK Incorporated.
  • (PMID = 20806764.001).
  • [ISSN] 1938-2367
  • [Journal-full-title] Orthopedics
  • [ISO-abbreviation] Orthopedics
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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26. Rozeman LB, Cleton-Jansen AM, Hogendoorn PC: Pathology of primary malignant bone and cartilage tumours. Int Orthop; 2006 Dec;30(6):437-44
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  • These tumours are clinically aggressive and often need extensive local and/or systemic treatment.
  • Whereas no other treatment but surgery is currently available for chondrosarcomas, osteosarcomas show an approximately 50-80% response rate to adjuvant chemotherapy.
  • In this report we will mainly focus on two of the most prevalent malignant bone tumours, conventional osteosarcoma and conventional chondrosarcoma, and use these to illustrate the problems with the diagnosis of bone sarcomas in general.
  • [MeSH-major] Bone Neoplasms / pathology. Chondrosarcoma / pathology. Osteosarcoma / pathology

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  • (PMID = 16944143.001).
  • [ISSN] 0341-2695
  • [Journal-full-title] International orthopaedics
  • [ISO-abbreviation] Int Orthop
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 35
  • [Other-IDs] NLM/ PMC3172744
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27. Bielack S, Jürgens H, Jundt G, Kevric M, Kühne T, Reichardt P, Zoubek A, Werner M, Winkelmann W, Kotz R: Osteosarcoma: the COSS experience. Cancer Treat Res; 2009;152:289-308
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  • [Title] Osteosarcoma: the COSS experience.
  • COSS, the interdisciplinary Cooperative German-Austrian-Swiss Osteosarcoma Study Group, was founded in 1977 and has since registered some 3,500 bone sarcoma patients from over 200 institutions.
  • For the purpose of the Pediatric and Adolescent Osteosarcoma Conference in Houston, March 2008, the outcomes of 2,464 consecutive patients with high-grade central osteosarcoma, who had been diagnosed between 1980 and 2005 and had been treated on neoadjuvant COSS protocols, were reviewed.
  • Intended treatment had included surgery and multidrug chemotherapy, with high-dose methotrexate, doxorubicin, cisplatin, and ifosfamide being used in most protocols.
  • Tumor response to preoperative chemotherapy was of independent prognostic significance.
  • [MeSH-major] Bone Neoplasms / therapy. Osteosarcoma / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Child, Preschool. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / therapy. Prognosis

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  • (PMID = 20213397.001).
  • [ISSN] 0927-3042
  • [Journal-full-title] Cancer treatment and research
  • [ISO-abbreviation] Cancer Treat. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
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28. El Ajmi M, Ksantini R, Chebbi F, Makni A, Rebai W, Daghfous A, Bedioui H, Fteriche F, Jouini M, Kacem M, Ben Safta Z: Abdominal metastasis of a parosteal osteosarcoma of the femur: an unusual cause of large-bowel obstruction. Acta Chir Belg; 2009 Oct;109(5):633-4
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  • [Title] Abdominal metastasis of a parosteal osteosarcoma of the femur: an unusual cause of large-bowel obstruction.
  • BACKGROUND: Parosteal osteosarcoma is a rare, well-differentiated, predominantly fibro-osseous variant of osteosarcoma.
  • It is regarded as a distinct form of osteosarcoma with better prognosis than conventional osteosarcoma.
  • AIM: We report an unusual case of abdominal mass recurrence of parosteal osteosarcoma of the left distal femur treated eight years previously with wide resection, hip disarticulation and chemotherapy, which presented as an acute abdomen: we discuss the clinical outcomes of this rare entity.
  • CASE PRESENTATION: We present a 54-year-old patient with low-grade parosteal osteosarcoma of the left distal femur.
  • Left total hip disarticulation was indicated after several local relapses of the tumour following extensive resection and chemotherapy.
  • Abdominal computed tomography showed a large abdominal calcified mass with dilated large bowel loops.
  • Biopsy of the lesion yielded grade III parosteal osteosarcoma material.
  • The patient received adjuvant chemotherapy, but the response was poor: six months later, the patient presented with a peristomal mass and two pulmonary metastases.
  • CONCLUSION: Abdominal recurrence of parosteal osteosarcoma of the distal femur eight years after definitive surgery is rare.
  • This case emphasises the importance of the long-term follow-up of patients with parosteal osteosarcoma.
  • [MeSH-major] Colonic Neoplasms / secondary. Femoral Neoplasms / pathology. Intestinal Obstruction / etiology. Osteosarcoma / secondary
  • [MeSH-minor] Colostomy. Female. Humans. Lung Neoplasms / secondary. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 19994810.001).
  • [ISSN] 0001-5458
  • [Journal-full-title] Acta chirurgica Belgica
  • [ISO-abbreviation] Acta Chir. Belg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Belgium
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29. Rodríguez-Arias CA, Lobato RD, Millán JM, Lagares A, de la Lama A, Alén JF: Parosteal osteosarcoma of the skull. Neurocirugia (Astur); 2001 Dec;12(6):521-4
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  • [Title] Parosteal osteosarcoma of the skull.
  • Parosteal osteosarcoma of the skull is a distinct surface bone tumor, with a better prognosis than conventional osteosarcoma.
  • The most common location is on the surface of the distal femur which accounts for 46-66% of the cases.
  • We describe the case of a man who developed a parosteal osteosarcoma arising from the occipital bone with extension to the parietal bone.
  • [MeSH-major] Occipital Bone / pathology. Osteosarcoma, Juxtacortical / pathology. Parietal Bone / pathology. Skull Neoplasms / pathology
  • [MeSH-minor] Cerebral Angiography. Chemotherapy, Adjuvant. Combined Modality Therapy. Craniotomy. Diagnosis, Differential. Disease Progression. Fatal Outcome. Humans. Lung Neoplasms / secondary. Lung Neoplasms / surgery. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / radiotherapy. Neoplasm Recurrence, Local / surgery. Osteosarcoma / diagnosis. Osteosarcoma / drug therapy. Osteosarcoma / pathology. Osteosarcoma / radiotherapy. Osteosarcoma / secondary. Radiotherapy, Adjuvant. Tomography, X-Ray Computed

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  • (PMID = 11787402.001).
  • [ISSN] 1130-1473
  • [Journal-full-title] Neurocirugía (Asturias, Spain)
  • [ISO-abbreviation] Neurocirugia (Astur)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 16
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30. Raymond AK, Jaffe N: Osteosarcoma multidisciplinary approach to the management from the pathologist's perspective. Cancer Treat Res; 2009;152:63-84
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  • [Title] Osteosarcoma multidisciplinary approach to the management from the pathologist's perspective.
  • Osteosarcoma is a primary malignant tumor of the bone in which proliferating neoplastic cells produce osteoid and/or bone, if only in small amounts.
  • However, osteosarcoma is not a single disease but a family of neoplasms, sharing the single histological finding of osseous matrix production in association with malignant cells.
  • These tumors generally occur in the metaphyseal portion of the medullary cavity of the long bone and are referred to as "Conventional Osteosarcoma."
  • The group is sub classified by the form of the dominant matrix present within the tumor, which may be bone, cartilage or fibrous tissue, and it is correspondingly referred to as osteoblastic, chondroblastic and fibroblastic osteosarcoma.
  • The remaining 25% of cases have unique parameters that allow reproducible identification of tumors which are biologically different from conventional osteosarcoma and are referred to as "Variants."
  • Because of their inherent biological difference from Conventional Osteosarcoma, the Variants identify cases which must be excluded from analysis of data pertaining to the treatment of the majority of cases: Conventional Osteosarcoma.
  • The diagnostic parameters of osteosarcoma must be sufficiently inclusive to identify all the members of this potentially lethal tumor.
  • Conversely, criteria for sub classification must be restricted to assure homogenous populations of tumors productively incorporating different biological behavior and the potential for development of unique treatment strategies which are different from those for Conventional Osteosarcoma.
  • This can be designated "Classification Based Therapy" or "Therapy Based Osteosarcoma."
  • With this background, we will discuss the highly disciplined approach to the management of osteosarcoma from the pathologist's perspective.
  • Factors governing the assessment of the response to preoperative chemotherapy will also be reviewed.
  • [MeSH-major] Bone Neoplasms / pathology. Bone Neoplasms / therapy. Osteosarcoma / pathology. Osteosarcoma / therapy

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  • (PMID = 20213386.001).
  • [ISSN] 0927-3042
  • [Journal-full-title] Cancer treatment and research
  • [ISO-abbreviation] Cancer Treat. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
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31. Kager L, Zoubek A, Dominkus M, Lang S, Bodmer N, Jundt G, Klingebiel T, Jürgens H, Gadner H, Bielack S, COSS Study Group: Osteosarcoma in very young children: experience of the Cooperative Osteosarcoma Study Group. Cancer; 2010 Nov 15;116(22):5316-24
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  • [Title] Osteosarcoma in very young children: experience of the Cooperative Osteosarcoma Study Group.
  • BACKGROUND: This study was conducted to investigate presentation, treatment, and outcome in very young children with osteosarcoma.
  • METHODS: The authors retrospectively analyzed the data of 2706 consecutive COSS patients with newly diagnosed osteosarcoma and identified 28 (1.0%) patients aged younger than 5 years at diagnosis.
  • Demographic, diagnostic, tumor, treatment-related variables, response, and survival data were analyzed.
  • RESULTS: Of the 28 preschoolers, 27 presented with high-grade central osteosarcoma of an extremity, and 1 had a secondary osteosarcoma of the orbit.
  • All patients received multiagent chemotherapy, and 11 of 18 analyzed tumors responded well (>90% necrosis) to neoadjuvant chemotherapy.
  • With a median follow-up of 4 years (6.2 years for survivors), 13 patients were alive.
  • Four patients never achieved a complete remission, and 11 developed recurrences; 14 of these 15 patients died.
  • Five-year overall and event-free survival probabilities were 51% (standard error of the mean [SE], 10%) and 48% (SE, 10%).
  • Better survival was correlated with good response to chemotherapy and later time period of diagnosis.
  • CONCLUSIONS: Osteosarcoma is extremely rare in preschool children.
  • [MeSH-major] Bone Neoplasms / diagnosis. Bone Neoplasms / therapy. Osteosarcoma / diagnosis. Osteosarcoma / therapy
  • [MeSH-minor] Arm. Chemotherapy, Adjuvant. Child, Preschool. Female. Humans. Leg. Male. Neoplasm Metastasis. Treatment Outcome

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  • [Copyright] Copyright © 2010 American Cancer Society.
  • (PMID = 20672353.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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32. McTiernan A, Whelan JS: A Phase II Study of Docetaxel for the Treatment of Recurrent Osteosarcoma. Sarcoma; 2004;8(2-3):71-6
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  • [Title] A Phase II Study of Docetaxel for the Treatment of Recurrent Osteosarcoma.
  • PURPOSE: To determine the response and toxicity of docetaxel in recurrent osteosarcoma and related spindle cell tumours of bone.
  • Diagnosis was: conventional osteosarcoma, 12 patients; periosteal osteosarcoma, one patient; and malignant fibrous histiocytoma of bone, one patient.
  • Initial chemotherapy had been with doxorubicin and cisplatin in 10 patients, and multiagent regimens in four.
  • Nine had been treated with second line chemotherapy before receiving docetaxel.
  • The principle toxicity was haematological, with a median neutrophil count of 0.9 (range 0-9.6).
  • CONCLUSION: Docetaxel at this dose and schedule is well tolerated, but is not associated with significant activity in patients with relapsed osteosarcoma.

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  • [Cites] J Chemother. 1998 Feb;10(1):69-76 [9531078.001]
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  • (PMID = 18521398.001).
  • [ISSN] 1357-714X
  • [Journal-full-title] Sarcoma
  • [ISO-abbreviation] Sarcoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
  • [Other-IDs] NLM/ PMC2395610
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33. Nedelcu T, Kubista B, Koller A, Sulzbacher I, Mosberger I, Arrich F, Trieb K, Kotz R, Toma CD: Livin and Bcl-2 expression in high-grade osteosarcoma. J Cancer Res Clin Oncol; 2008 Feb;134(2):237-44
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  • [Title] Livin and Bcl-2 expression in high-grade osteosarcoma.
  • AIMS: The evaluation of prognosis in patients with osteosarcoma is limited to clinical parameters.
  • The aim of this study was to determine if Livin and Bcl-2, acting as antiapoptotic proteins through different mechanisms, are expressed in osteosarcoma, and whether they can be used as prognostic markers in human osteosarcoma.
  • METHODS: Tumor specimens of 29 patients with high-grade central osteosarcoma, with complete clinical follow-up for a minimum of 5 years, were studied.
  • Results were correlated with the histological response to chemotherapy, 5-year disease-free and 5-year overall survival.
  • Nuclear expression was significantly correlated with a decreased overall survival (P < 0.0002) compared with those patients without nuclear expression.
  • CONCLUSIONS: The results of this study indicate that Bc1-2 and Livin are highly expressed in osteosarcoma cells and that possibly, the evaluation of nuclear Livin expression might be a useful prognostic marker in osteosarcoma.
  • [MeSH-major] Adaptor Proteins, Signal Transducing / metabolism. Bone Neoplasms / metabolism. Inhibitor of Apoptosis Proteins / metabolism. Neoplasm Proteins / metabolism. Osteosarcoma / metabolism. Proto-Oncogene Proteins c-bcl-2 / metabolism
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / metabolism. Chemotherapy, Adjuvant. Child. Female. Follow-Up Studies. Humans. Immunoenzyme Techniques. Male. Middle Aged. Neoadjuvant Therapy. Prognosis. Survival Rate

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  • (PMID = 17632732.001).
  • [ISSN] 1432-1335
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Adaptor Proteins, Signal Transducing; 0 / BIRC7 protein, human; 0 / Biomarkers, Tumor; 0 / Inhibitor of Apoptosis Proteins; 0 / Neoplasm Proteins; 0 / Proto-Oncogene Proteins c-bcl-2
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34. Asavamongkolkul A, Waikakul S, Phimolsarnti R, Kiatisevi P, Wangsaturaka P: Endoprosthetic reconstruction for malignant bone and soft-tissue tumors. J Med Assoc Thai; 2007 Apr;90(4):706-17
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  • [Title] Endoprosthetic reconstruction for malignant bone and soft-tissue tumors.
  • BACKGROUND: Nowadays, the results of the management of malignant bone and soft-tissue tumors have been dramatically improved because of the advance in imaging, chemotherapy, radiation therapy, and surgical techniques.
  • Patients can have longer survival times with limb-salvage surgery.
  • OBJECTIVE: To report the preliminary results of 32 endoprosthetic reconstructions following malignant bone and soft-tissue tumor resection.
  • MATERIAL AND METHOD: Since September 1988, the authors have performed 188 limb-salvage surgical operations for the treatment of musculoskeletal tumors at Siriraj Hospital.
  • From March 1994 to July 2006, 32 endoprosthetic reconstructions were performed on 30 patients following malignant bone or soft-tissue tumor removal.
  • There were 16 males and 14 females with a mean age of 28 years (range 10-73).
  • The diagnosis was conventional osteosarcoma in 16 patients, parosteal osteosarcoma in two patients, chondrosarcoma in two patients, leiomyosarcoma in two patients, failed allograft in two patients and one patient each of periosteal osteosarcoma, Ewing's sarcoma, Gorham's disease, synovial sarcoma, malignant fibrous histiocytoma, metastatic renal cell carcinoma, and prosthetic loosening.
  • Wide excision was performed with a mean length of 18.5 cm (range 10-41).
  • Five proximal femurs, 17 distal femurs, 1 total femur 3 proximal tibias, 1 intercalary tibia, 4 proximal humerus and 1 distal humerus were used for reconstruction.
  • RESULTS: The mean follow-up time was 26 months (range 6-128.7).
  • CONCLUSION: Endoprosthetic reconstruction could yield satisfactory results as a wide excision and limb-salvage for patients with malignant bone and soft-tissue tumors.
  • [MeSH-major] Bone Neoplasms / surgery. Limb Salvage. Osteosarcoma / surgery. Sarcoma, Ewing / surgery. Soft Tissue Neoplasms / surgery

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  • (PMID = 17487125.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Thailand
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35. Kollert M, Basten O, Delling G, Bockmühl U: [Clear cell chondrosarcoma of the larynx. A rare tumor in an uncommon location]. HNO; 2005 Apr;53(4):357-60
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  • [Transliterated title] Klarzellchondrosarkom des Larynx. Ein sehr seltener Tumor in einer aussergewöhnlichen Lokalisation.
  • The therapy of choice for this tumor is wide surgical resection.
  • Additional radio- and/or chemotherapy are not recommended.
  • Histologically, the clear cell chondrosarcoma can be easily confused with the highly malignant osteosarcoma or the conventional chondrosarcoma, both requiring more aggressive treatment.
  • [MeSH-major] Chondrosarcoma / diagnosis. Chondrosarcoma / surgery. Dyspnea / diagnosis. Laryngeal Neoplasms / diagnosis. Laryngeal Neoplasms / surgery. Laryngostenosis / diagnosis. Sarcoma, Clear Cell / diagnosis. Sarcoma, Clear Cell / surgery

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  • (PMID = 15316626.001).
  • [ISSN] 0017-6192
  • [Journal-full-title] HNO
  • [ISO-abbreviation] HNO
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
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36. Benjamin RS, Patel SR: Pediatric and adult osteosarcoma: comparisons and contrasts in presentation and therapy. Cancer Treat Res; 2009;152:355-63
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  • [Title] Pediatric and adult osteosarcoma: comparisons and contrasts in presentation and therapy.
  • Most data on osteosarcoma is derived from pediatric studies.
  • Although the majority of adult patients with osteosarcoma are young adults, who might be treated in a similar fashion, experience derived from a slightly older population is helpful in directing therapy.
  • We treated a series of 123 patients with osteosarcoma of the extremities with adriamycin and cisplatin as induction therapy.
  • Sequential addition of methotrexate and methotrexate plus ifosfamide in subsequent cohorts improved the continuous relapse-free survival of poor responders such that overall survival improvement was noted in the group where therapy was modified by adding both agents to those with <90% tumor necrosis.
  • Patients with chondroblastic osteosarcoma with poor necrosis had a trend towards improved continuous relapse-free survival compared with other patients with conventional osteosarcoma.
  • Histologic variants of osteosarcoma except telangiectatic osteosarcoma had a worse prognosis than those with conventional osteosarcoma.
  • The variants, especially dedifferentiated parosteal osteosarcoma and dedifferentiated well-differentiated intraosseous osteosarcoma are more common in adults than children, accounting for some of the inferior prognosis in adults.
  • Older patients obviously cannot tolerate the doses of therapy given to children and young adults, again decreasing the chances of successful treatment.
  • Patients with secondary osteosarcoma are often much older as are many with osteosarcomas of the pelvis and jaw.
  • An attempt to intensify therapy in poor-prognosis patients with a three-drug regimen of adriamycin, cisplatin, and ifosfamide with peripheral stem cell support was unsuccessful at prolonging relapse-free survival, and we no longer use that approach.
  • [MeSH-major] Bone Neoplasms / drug therapy. Osteosarcoma / drug therapy

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  • (PMID = 20213401.001).
  • [ISSN] 0927-3042
  • [Journal-full-title] Cancer treatment and research
  • [ISO-abbreviation] Cancer Treat. Res.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] United States
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37. Bacci G, Ferrari S, Bertoni F, Longhi A, Bacchini P, Giacomini S, Forni C: A comment and update on "Does the histological subtype of high-grade central osteosarcoma influence the response to treatment with chemotherapy and does it affect overall survival?". Eur J Cancer; 2003 Mar;39(4):548-9
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  • [Title] A comment and update on "Does the histological subtype of high-grade central osteosarcoma influence the response to treatment with chemotherapy and does it affect overall survival?".
  • [MeSH-major] Bone Neoplasms / pathology. Osteosarcoma / pathology
  • [MeSH-minor] Clinical Trials as Topic. Humans. Treatment Outcome

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  • [CommentOn] Eur J Cancer. 2002 Jun;38(9):1218-25 [12044509.001]
  • (PMID = 12751388.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] England
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