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1. Bertoni F, Bacchini P, Staals EL, Davidovitz P: Dedifferentiated parosteal osteosarcoma: the experience of the Rizzoli Institute. Cancer; 2005 Jun 1;103(11):2373-82
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  • [Title] Dedifferentiated parosteal osteosarcoma: the experience of the Rizzoli Institute.
  • BACKGROUND: Dedifferentiated parosteal osteosarcoma (DPOS) is a variant of osteosarcoma in which a high-grade sarcoma coexists with a conventional parosteal osteosarcoma (c-POS), either at presentation (synchronous type) or at the time of recurrence (metachronous type).
  • METHODS: In a series of 120 patients with parosteal osteosarcoma who were seen at the Rizzoli Institute from 1958 to 2000, the authors identified 29 patients who were diagnosed with DPOS.
  • The authors reviewed the clinical and radiologic features, histologic sections, treatments, and outcomes in this group of patients with DPOS.
  • Histologically, the dedifferentiated component was high-grade osteoblastic osteosarcoma in 14 patients, fibroblastic osteosarcoma in 10 patients, giant cell-rich osteosarcoma in 3 patients, and chondroblastic osteosarcoma in 2 patients.
  • Twenty-eight patients underwent surgery, and 18 of those patients received chemotherapy (5 patients received neoadjuvant chemotherapy, and 13 patients received adjuvant).
  • Of the nine patients who died, one patient received no treatment, five patients underwent surgery (with three patients achieving adequate margins) in combination with chemotherapy, and three patients underwent surgery only (with adequate margins achieved).
  • Of the 20 patients who remained alive, 13 patients underwent surgery (with 10 patients achieving adequate margins) in combination with chemotherapy, whereas 7 patients underwent surgery only (all with adequate margins).
  • [MeSH-major] Bone Neoplasms / pathology. Cell Differentiation. Osteosarcoma, Juxtacortical / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Survival Rate. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 15852358.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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2. Revell MP, Deshmukh N, Grimer RJ, Carter SR, Tillman RM: Periosteal Osteosarcoma: A Review of 17 Cases with Mean Follow-up of 52 Months. Sarcoma; 2002;6(4):123-30
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  • [Title] Periosteal Osteosarcoma: A Review of 17 Cases with Mean Follow-up of 52 Months.
  • PURPOSE: Periosteal osteosarcomas are rare cartilage-rich bone tumours characterized by a juxtacortical eccentric position and are normally regarded oncologically as of intermediate to high grade.Their low incidence is mirrored by a small number of reported cases in the world literature.
  • While there is general agreement that wide surgical excision is required, there is a paucity of evidence regarding adjuvant therapy.
  • Our policy was to use chemotherapy when the tumour showed any features of high grade.
  • DISCUSSION: Comparison of survival with existing studies is made to draw conclusions regarding future treatment of this condition in terms of surgical and adjuvant approaches.

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  • (PMID = 18521348.001).
  • [ISSN] 1357-714X
  • [Journal-full-title] Sarcoma
  • [ISO-abbreviation] Sarcoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
  • [Other-IDs] NLM/ PMC2395495
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3. Donaldson ME, Geist JR, Daley TD: Osteosarcoma of the jaws in children. Int J Paediatr Dent; 2004 Jan;14(1):54-60
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  • [Title] Osteosarcoma of the jaws in children.
  • Two cases of osteosarcoma of the jaws in children are reported.
  • She was found to have chondroblastic osteosarcoma extending through the left maxillary alveolar process and sinus.
  • Following surgery and chemotherapy, the patient has been free of disease for 7 years.
  • The second patient, an 8-year-old boy, was diagnosed with juxtacortical (parosteal) osteosarcoma of the mandible, which is a less aggressive variant of the neoplasm.
  • It is believed that this is the youngest patient reported to date with juxtacortical osteosarcoma of the jaws.
  • He was treated by block resection of the right side of the mandible and is free of disease 3(1/2) years later.

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  • (PMID = 14706029.001).
  • [ISSN] 0960-7439
  • [Journal-full-title] International journal of paediatric dentistry
  • [ISO-abbreviation] Int J Paediatr Dent
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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4. Schwab JH, Antonescu CR, Athanasian EA, Boland PJ, Healey JH, Morris CD: A comparison of intramedullary and juxtacortical low-grade osteogenic sarcoma. Clin Orthop Relat Res; 2008 Jun;466(6):1318-22
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  • [Title] A comparison of intramedullary and juxtacortical low-grade osteogenic sarcoma.
  • While low-grade juxtacortical and low-grade intramedullary osteogenic sarcomas are histologically indistinguishable, they have been studied as separate entities.
  • We retrospectively reviewed the clinical, radiographic, histologic features and treatment of 59 patients treated surgically to compare the rate of local recurrence, grade progression, and survival between low-grade intramedullary and low-grade juxtacortical osteogenic sarcoma.
  • Forty-five (76%) patients were treated for low-grade juxtacortical osteogenic sarcoma and 14 (24%) were treated for low-grade intramedullary osteogenic sarcoma.
  • Dedifferentiated lesions were treated with adjuvant chemotherapy in 16 of 17 cases.
  • Low-grade intramedullary and low-grade juxtacortical osteogenic sarcoma were clinically indistinguishable with identical rates of local recurrence, distant metastases, dedifferentiation, and survival.
  • LEVEL OF EVIDENCE: Level III, therapeutic study.
  • [MeSH-major] Bone Neoplasms / diagnosis. Bone Neoplasms / mortality. Osteosarcoma, Juxtacortical / diagnosis. Osteosarcoma, Juxtacortical / mortality. Sarcoma, Ewing / diagnosis. Sarcoma, Ewing / mortality
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Cohort Studies. Disease-Free Survival. Female. Humans. Male. Middle Aged. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 18425560.001).
  • [ISSN] 1528-1132
  • [Journal-full-title] Clinical orthopaedics and related research
  • [ISO-abbreviation] Clin. Orthop. Relat. Res.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2384019
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5. Kilpatrick SE, Geisinger KR, King TS, Sciarrotta J, Ward WG, Gold SH, Bos GD: Clinicopathologic analysis of HER-2/neu immunoexpression among various histologic subtypes and grades of osteosarcoma. Mod Pathol; 2001 Dec;14(12):1277-83
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  • [Title] Clinicopathologic analysis of HER-2/neu immunoexpression among various histologic subtypes and grades of osteosarcoma.
  • Recently, some have reported a relationship between increased immunohistochemical expression in osteosarcoma and poor clinical outcome.
  • Despite limited data, a pilot trial of Herceptin, which targets the oncogene product, has been initiated for the therapy of some metastatic osteosarcomas (CCG-P9852).
  • Archival formalin-fixed, paraffin-embedded tissue obtained from 41 patients diagnosed with osteosarcoma was examined immunohistochemically by 2 antibodies against the HER-2/neu oncogene product: CB-11 (monoclonal, 1/100) and Oncor (polyclonal, 1/200).
  • All but one tumor (case of recurrent dedifferentiated parosteal osteosarcoma) represented primary tumor samples; when applicable, only prechemotherapy biopsies were analyzed.
  • The study sample included the full spectrum of histologic subtypes and grades of osteosarcoma (25 conventional high grade; 3 telangiectatic; 1 small cell; 6 parosteal; 1 periosteal; and 5 low-grade intramedullary).
  • Complete membranous positivity, considered prognostically significant in breast cancer, was not seen in any of our osteosarcoma cases.
  • The intensity of the cytoplasmic staining (0, 1-3+) did not correlate with histologic subtype/grade, response to chemotherapy (<90% versus > or = 90% necrosis), metastasis, or survival.
  • Immunohistochemical overexpression of the HER-2/neu oncogene, defined as complete membranous positivity, is not present in our series of osteosarcomas.
  • Cytoplasmic positivity is observed in most osteosarcomas, irrespective of histologic subtype/grade, and is not associated with response to preoperative chemotherapy or disease progression.
  • [MeSH-major] Bone Neoplasms / metabolism. Osteosarcoma / metabolism. Receptor, ErbB-2 / biosynthesis

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  • (PMID = 11743051.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Neoplasm; EC 2.7.10.1 / Receptor, ErbB-2
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6. 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.
  • Thirteen patients had lung metastases and one intra-abdominal disease.
  • Two patients had stable disease, and one patient a mixed response.
  • 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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  • (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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7. Samardziski M, Zafiroski G, Tolevska C, Konstadinova-Kunovska S, Vasilevska V: Parosteal osteosarcoma. Bratisl Lek Listy; 2009;110(4):240-4
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  • [Title] Parosteal osteosarcoma.
  • In this retrospective clinical study, 6 cases of osteosarcoma of the bone have been analyzed.
  • Five patients were with parosteal osteosarcoma and one with periosteal osteosarcoma.
  • The history analysis of the patients showed misinterpreted diagnosis in 50% of the cases, with 83.3% rate of local recurrence, 33.3% of metastases and 33.3% of mortality.
  • The clinical and histopathological findings (identical with those reviewed in the literature) confirmed occurrence of two biologically different types of parosteal osteosarcoma: predominant type is originally "benign" but has a definite malignant potential, causing metastases after long symptom-free interval.
  • The other type is highly malignant from the beginning.
  • More radical surgery is recommended for the latter category of tumors, followed by chemotherapy.
  • [MeSH-major] Bone Neoplasms / diagnosis. Osteosarcoma, Juxtacortical / diagnosis
  • [MeSH-minor] Adolescent. Adult. Child. Female. Femoral Neoplasms / diagnosis. Humans. Humerus. Male. Tibia. Young Adult

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  • (PMID = 19507652.001).
  • [ISSN] 0006-9248
  • [Journal-full-title] Bratislavské lekárske listy
  • [ISO-abbreviation] Bratisl Lek Listy
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Slovakia
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8. Muir TM, Lehman TP, Meyer WH: Periosteal osteosarcoma in the hand of a pediatric patient: a case report. J Hand Surg Am; 2008 Feb;33(2):266-8
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  • [Title] Periosteal osteosarcoma in the hand of a pediatric patient: a case report.
  • We report a case of periosteal osteosarcoma, an uncommon juxtacortical osteosarcoma variant, in the metacarpal of a 5-year-old girl treated with wide excision and chemotherapy with no recurrence at 25 months.
  • [MeSH-major] Bone Neoplasms / pathology. Osteosarcoma / pathology. Periosteum / pathology
  • [MeSH-minor] Chemotherapy, Adjuvant. Child, Preschool. Female. Humans. Metacarpal Bones / pathology. Metacarpal Bones / surgery. Tendons / surgery. Thumb / surgery. Trapezium Bone / surgery

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  • [ErratumIn] J Hand Surg [Am]. 2008 May-Jun;33(5):787
  • (PMID = 18294553.001).
  • [ISSN] 0363-5023
  • [Journal-full-title] The Journal of hand surgery
  • [ISO-abbreviation] J Hand Surg Am
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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9. 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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10. 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].
  • [Transliterated title] Das parossale Osteosarkom Klinische und therapeutische Aspekte.
  • 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.
  • Often a benign tumor is imitated so that finding the correct diagnosis is indispensable.
  • 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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11. 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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12. Azura M, Vanel D, Alberghini M, Picci P, Staals E, Mercuri M: Parosteal osteosarcoma dedifferentiating into telangiectatic osteosarcoma: importance of lytic changes and fluid cavities at imaging. Skeletal Radiol; 2009 Jul;38(7):685-90
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  • [Title] Parosteal osteosarcoma dedifferentiating into telangiectatic osteosarcoma: importance of lytic changes and fluid cavities at imaging.
  • PURPOSE: This study was performed to assess the imaging findings in cases of parosteal osteosarcoma dedifferentiated into telangiectatic osteosarcoma.
  • Parosteal osteosarcoma is a low-grade well-differentiated malignant tumor.
  • Only one case of differentiation into a telangiectatic osteosarcoma has been reported.
  • As it has practical consequences, with a need for aggressive chemotherapy, we looked for this rather typical imaging pattern.
  • MATERIALS AND METHODS: Review of 199 cases of surface osteosarcomas (including 86 parosteal, of which 23 were dedifferentiated) revealed lesions suggesting a possible telangiectatic osteosarcoma on imaging examinations in five cases (cavities with fluid).
  • RESULTS: Lesions involved the distal femur, proximal tibia, and proximal humerus.
  • The parosteal osteosarcoma was a sclerotic, regular mass, attached to the cortex.
  • CONCLUSION: Knowledge of this highly suggestive pattern should help guide the initial biopsy to diagnose the two components of the tumor, and guide aggressive treatment.
  • [MeSH-major] Bone Neoplasms / diagnostic imaging. Femoral Neoplasms / diagnostic imaging. Osteosarcoma / classification. Osteosarcoma / diagnostic imaging. Telangiectasis / diagnostic imaging
  • [MeSH-minor] Adult. Cell Differentiation. Humans. Male. Tomography, X-Ray Computed. Young Adult

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  • [CommentIn] Skeletal Radiol. 2010 Jan;39(1):69; author reply 71 [19826810.001]
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  • (PMID = 19271217.001).
  • [ISSN] 1432-2161
  • [Journal-full-title] Skeletal radiology
  • [ISO-abbreviation] Skeletal Radiol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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13. Wines A, Bonar F, Lam P, McCarthy S, Stalley P: Telangiectatic dedifferentiation of a parosteal osteosarcoma. Skeletal Radiol; 2000 Oct;29(10):597-600
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  • [Title] Telangiectatic dedifferentiation of a parosteal osteosarcoma.
  • A unique case of parosteal osteosarcoma (POS) of the proximal femur, with areas of telangiectatic dedifferentiation, in a 28-year-old woman is reported.
  • A biopsy diagnosis of POS was established.
  • The patient was treated with two cycles of intraarterial chemotherapy, followed by limb salvage surgery.
  • Histological examination of the resected specimen showed POS with areas of dedifferentiation composed of highgrade telangiectatic osteosarcoma with associated secondary aneurysmal bone cyst change.
  • [MeSH-major] Femoral Neoplasms / diagnosis. Osteosarcoma, Juxtacortical / diagnosis
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Cysts, Aneurysmal / diagnosis. Female. Femur / pathology. Humans. Infusions, Intra-Arterial. Magnetic Resonance Imaging. Osteosarcoma / diagnosis

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  • (PMID = 11127684.001).
  • [ISSN] 0364-2348
  • [Journal-full-title] Skeletal radiology
  • [ISO-abbreviation] Skeletal Radiol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 13
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14. Futani H, Okayama A, Maruo S, Kinoshita G, Ishikura R: The role of imaging modalities in the diagnosis of primary dedifferentiated parosteal osteosarcoma. J Orthop Sci; 2001;6(3):290-4
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  • [Title] The role of imaging modalities in the diagnosis of primary dedifferentiated parosteal osteosarcoma.
  • Dedifferentiated parosteal osteosarcoma (dd-POS) is defined as high-grade sarcomatous components coexisting with low-grade POS components.
  • With regard to the histological diagnosis of dd-POS, the sampling of a small area of dedifferentiation through the densely mineralized POS can be a problem.
  • We report a patient in whom dedifferentiation was shown by computed tomography (CT) and magnetic resonance imaging (MRI).
  • Neoadjuvant chemotherapy was administered, followed by wide resection and adjuvant chemotherapy.
  • Based on the initial diagnosis and, consequently, the optimal treatment of combined chemotherapy and wide resection, our patient showed a good clinical outcome.
  • [MeSH-major] Bone Neoplasms / diagnosis. Bone Neoplasms / pathology. Diagnostic Imaging. Fibula. Osteosarcoma, Juxtacortical / diagnosis. Osteosarcoma, Juxtacortical / pathology
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Gadolinium. Humans. Image Enhancement. Lung Neoplasms / secondary. Magnetic Resonance Imaging. Male. Tomography, X-Ray Computed


15. Goto T, Okuma T, Ogura K, Imanishi J, Hozumi T, Kondo T: [Indication of chemotherapy according to histological type of musculoskeletal sarcomas]. Gan To Kagaku Ryoho; 2009 Feb;36(2):199-203
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  • [Title] [Indication of chemotherapy according to histological type of musculoskeletal sarcomas].
  • In high-grade musculoskeletal sarcomas, adjuvant chemotherapy is often performed to prevent distant metastases.
  • As the efficacy of chemotherapy varies according to the histological type of sarcoma, its indication is determined according to the histological type and the stage.
  • Prognoses are poor in patients with osteosarcoma, Ewing's sarcoma, or rhabdomyosarcoma, when surgery alone is performed.
  • However, because these sarcomas are chemosensitive, their prognoses are improved with adjuvant chemotherapy, so it is absolutely necessary.
  • Drugs commonly used for osteosarcoma include adriamycin, cisplatin, methotrexate, vincristine, and ifosfamide.
  • For Ewing's sarcoma and rhabdomyosarcoma, vincristine, actinomycin-D, cyclophosphamide, etoposide, and ifosfamide are commonly used.
  • On the other hand, the efficacy of chemotherapy is unclear in most of the non-round cell sarcomas, e. g., malignant fibrous histiocytoma, pleomorphic liposarcoma, and leiomyosarcoma, so adjuvant chemotherapy is relatively indicated and often performed preoperatively.
  • Postoperative chemotherapy is performed when the preoperative chemotherapy is effective.
  • Among them, the key drugs are adriamycin and ifosfamide.
  • For chemoresistant sarcomas, e. g., chondrosarcoma, chordoma, alveolar soft part sarcoma, chemotherapy is rarely indicated, even if the tumor is histologically high grade and large.
  • Low-grade musculoskeletal sarcomas, e. g., low-grade chondrosarcoma, central low-grade osteosarcoma, parosteal osteosarcoma, well-differentiated liposarcoma, and dermatofibrosarcoma protuberans, are well cured only by surgical excision, and adjuvant chemotherapy is therefore not indicated.
  • Superficially-located, small-size non-round cell sarcomas, even though histologically high grade, are well healed only by surgical excision, and adjuvant chemotherapy is rarely indicated.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Musculoskeletal Diseases / drug therapy. Musculoskeletal Diseases / pathology. Neoplasms, Muscle Tissue / drug therapy. Neoplasms, Muscle Tissue / pathology. Sarcoma / drug therapy. Sarcoma / pathology
  • [MeSH-minor] Combined Modality Therapy. Humans

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  • (PMID = 19223736.001).
  • [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] 0 / Antineoplastic Agents
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16. Kido A, Schneider-Stock R, Hauptmann K, Roessner A: Telomerase activity in juxtacortical and conventional high-grade osteosarcomas: correlation with grade, proliferative activity and clinical response to chemotherapy. Cancer Lett; 2003 Jun 30;196(1):109-15
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  • [Title] Telomerase activity in juxtacortical and conventional high-grade osteosarcomas: correlation with grade, proliferative activity and clinical response to chemotherapy.
  • Seven samples from seven patients with juxtacortical osteosarcomas, and 27 samples from 19 patients with conventional high-grade osteosarcomas were investigated for a possible correlation between telomerase activity and clinicopathological features such as age, sex, and response to chemotherapy.
  • Of seven juxtacortical osteosarcomas, telomerase activity was weakly positive in three parosteal osteosarcomas, and highly positive in one parosteal osteosarcoma.
  • In contrast, of 27 conventional high-grade osteosarcomas, telomerase activity was weakly positive in eight tumors and highly positive in three.
  • Of all samples, 44.1% of the osteosarcomas showed telomerase activity (57.1% of juxtacortical and 40.7% of conventional osteosarcomas).
  • The majority of poor responders to chemotherapy showed no telomerase activity (nine of 11), whereas five of seven good responders showed strong or weak telomerase activity.
  • There was a significant correlation between telomerase activity and the response to chemotherapy (P<0.05).
  • Telomerase activity was not correlated with MIB-1 proliferation index, age at the time of surgery, or sex.
  • [MeSH-major] Bone Neoplasms / enzymology. Osteosarcoma / enzymology. Osteosarcoma, Juxtacortical / drug therapy. Osteosarcoma, Juxtacortical / enzymology. Telomerase / metabolism

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  • (PMID = 12860297.001).
  • [ISSN] 0304-3835
  • [Journal-full-title] Cancer letters
  • [ISO-abbreviation] Cancer Lett.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
  • [Chemical-registry-number] EC 2.7.7.49 / Telomerase
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17. Hazan EJ, Hornicek FJ, Tomford W, Gebhardt MC, Mankin HJ: The effect of adjuvant chemotherapy on osteoarticular allografts. Clin Orthop Relat Res; 2001 Apr;(385):176-81
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  • [Title] The effect of adjuvant chemotherapy on osteoarticular allografts.
  • Two hundred lower extremity osteoarticular allografts (in 200 patients) performed for aggressive or malignant bone tumors between 1976 and 1997 included 124 grafts of the distal femur, 46 of the proximal tibia, and 30 of the proximal femur.
  • Seventy-four patients did not receive chemotherapy, and 126 received either adjuvant or neoadjuvant therapy.
  • The diagnoses, mean ages, and length of followup were different for the two groups because most of the patients in the chemotherapy group had osteosarcoma, whereas the largest number in the control group had chondrosarcoma or parosteal osteosarcoma.
  • The extent of the surgery was essentially the same for both patient groups, as is reflected by a low recurrence rate (7% for the control and 6% for the chemotherapy group).
  • A statistical comparison of the various parameters showed that the infection, fracture, and amputation rates were the same, but the nonunion rate was markedly increased in the patients who received chemotherapy (32% versus 12%).
  • Cox regression and Kaplan-Meier studies showed that chemotherapy had a significant effect on outcome, with the success rates for the two groups being quite different (72% versus 56%).
  • The results for the distal femur showed a greater effect than for either the proximal tibia or the proximal femur.
  • Analysis of these data suggest the distal femur is perhaps the most prone to healing problems, possibly based in part on the extent of the surgery.
  • A final study supports the concept that the results improved in later years, suggesting a modification or application of the drugs used, better selection of patients, and improvements in surgical technique.
  • [MeSH-major] Bone Neoplasms / surgery. Bone Transplantation. Chondrosarcoma / surgery. Osteosarcoma / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Chemotherapy, Adjuvant. Child. Female. Femur / transplantation. Humans. Male. Middle Aged. Reconstructive Surgical Procedures. Tibia / transplantation. Transplantation, Homologous

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  • (PMID = 11302311.001).
  • [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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18. 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).
  • Sixteen patients are continuously free of the disease, two are alive with the disease, two had no evidence of the disease, nine died of the disease, and one patient died from complication of hypertension.
  • 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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19. 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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20. Grimer RJ, Bielack S, Flege S, Cannon SR, Foleras G, Andreeff I, Sokolov T, Taminiau A, Dominkus M, San-Julian M, Kollender Y, Gosheger G, European Musculo Skeletal Oncology Society: Periosteal osteosarcoma--a European review of outcome. Eur J Cancer; 2005 Dec;41(18):2806-11
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  • [Title] Periosteal osteosarcoma--a European review of outcome.
  • Periosteal osteosarcoma is a rare primary malignant bone tumour.
  • Treatment is by surgical excision, but controversy remains about the value of chemotherapy.
  • A total of 81 patients had chemotherapy, of whom 50 had neoadjuvant chemotherapy.
  • There was no standard chemotherapy regime, but all patients receiving chemotherapy were given doxorubicin combined with at least one other agent.
  • Eight patients developed local recurrence, of whom 5 died.
  • The use of chemotherapy was not shown to be a prognostic factor, but was used in two-thirds of the patients in this study.
  • [MeSH-major] Bone Neoplasms / drug therapy. Osteosarcoma / drug therapy
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Aged. Child. Europe / epidemiology. Female. Fibula. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local / etiology. Neoplasm Recurrence, Local / mortality. Survival Analysis. Tibia. Treatment Outcome

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  • (PMID = 16290134.001).
  • [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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21. Hoshi M, Matsumoto S, Manabe J, Tanizawa T, Shigemitsu T, Takeuchi K, Kawaguchi N: Report of four cases with high-grade surface osteosarcoma. Jpn J Clin Oncol; 2006 Mar;36(3):180-4
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  • [Title] Report of four cases with high-grade surface osteosarcoma.
  • High-grade surface osteosarcoma is the rarest of the three types of surface osteosarcoma.
  • Four cases with high-grade surface osteosarcoma arising from the distal femur and tibia are reported in this study.
  • Radiologically, three cases presented characteristic appearances suggesting high-grade bone-forming sarcoma arising from the bone surface; however, one case was similar to other juxtacortical lesions such as periosteal and parosteal osteosarcoma, which typically have a better prognosis than high-grade surface osteosarcoma.
  • Therefore, all cases underwent biopsy to determine a definitive diagnosis.
  • Our strategy of treatment for high-grade surface osteosarcoma was a combination of wide resection and pre-/post-operative chemotherapy, equivalent to the treatment for conventional intramedullary osteosarcoma.
  • At the last follow-up, two cases were still undergoing chemotherapy, one case was continuously disease free during the follow-up period of 81 months, and one patient was living with no evidence of disease 60 months after surgery.
  • The aim of this study is to report the clinical information, oncological outcome and appropriate treatment for high-grade surface osteosarcoma.
  • [MeSH-major] Bone Neoplasms / surgery. Femoral Neoplasms / surgery. Osteosarcoma / surgery
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Diagnosis, Differential. Female. Humans. Magnetic Resonance Imaging. Male. Tibia / surgery. Tomography, X-Ray Computed. Treatment Outcome. Turner Syndrome / complications

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  • (PMID = 16533804.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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22. Sabo D, Bernd L, Buchner M, Treiber M, Wannenmacher M, Ewerbeck V, Parsch D: [Intraoperative extracorporeal irradiation and replantation in local treatment of primary malignant bone tumors]. Orthopade; 2003 Nov;32(11):1003-12
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  • [Title] [Intraoperative extracorporeal irradiation and replantation in local treatment of primary malignant bone tumors].
  • In 13 patients with primary malignant bone tumors (10 Ewing's sarcoma, 1 parosteal osteosarcoma, 1 adamantinoma recurrence, and 1 MFH) local therapy was performed as intraoperative extracorporeal irradiation and replantation (IEIR) of the involved bone segment (5 tibia, 2 femur, and 6 pelvis).
  • Of the 13 patients (69%), 9 are alive at the time of the follow-up (5 CDF, 4 AWM(treated)) and 4 patients died of disease (DOD).
  • IEIR must be seen as an extraordinary reconstruction procedure in cases where established procedures such as endoprosthesis, biological reconstructions, or rotationplasties cannot be used or are refused by the patient.
  • [MeSH-minor] Adolescent. Adult. Aged. Ameloblastoma / drug therapy. Ameloblastoma / pathology. Ameloblastoma / radiotherapy. Ameloblastoma / surgery. Child, Preschool. Combined Modality Therapy. Female. Femoral Neoplasms / drug therapy. Femoral Neoplasms / pathology. Femoral Neoplasms / radiotherapy. Femoral Neoplasms / surgery. Follow-Up Studies. Histiocytic Sarcoma / drug therapy. Histiocytic Sarcoma / pathology. Histiocytic Sarcoma / radiotherapy. Histiocytic Sarcoma / surgery. Humans. Male. Neoadjuvant Therapy. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / radiotherapy. Neoplasm Recurrence, Local / surgery. Neoplasm Staging. Osteosarcoma / drug therapy. Osteosarcoma / pathology. Osteosarcoma / radiotherapy. Osteosarcoma / surgery. Radiotherapy Dosage. Sarcoma, Ewing / drug therapy. Sarcoma, Ewing / pathology. Sarcoma, Ewing / radiotherapy. Sarcoma, Ewing / surgery. Tibia / pathology. Tibia / surgery

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  • (PMID = 14615850.001).
  • [ISSN] 0085-4530
  • [Journal-full-title] Der Orthopade
  • [ISO-abbreviation] Orthopade
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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23. Chen W, Zhu H, Zhang L, Li K, Su H, Jin C, Zhou K, Bai J, Wu F, Wang Z: Primary bone malignancy: effective treatment with high-intensity focused ultrasound ablation. Radiology; 2010 Jun;255(3):967-78
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary bone malignancy: effective treatment with high-intensity focused ultrasound ablation.
  • From December 1997 to November 2004, 80 patients with a primary bone malignancy-60 with stage IIb disease and 20 with stage III disease (Enneking staging system)-were treated with US-guided high-intensity focused ultrasound ablation.
  • High-intensity focused ultrasound ablation combined with chemotherapy was performed in 62 patients with osteosarcoma, one patient with periosteal osteosarcoma, and three patients with Ewing sarcoma.
  • The remaining 14 patients had chondrosarcoma, giant cell bone cancer, periosteal sarcoma, or an unknown malignancy and were treated with high-intensity focused ultrasound ablation only.
  • Magnetic resonance (MR) imaging or computed tomography (CT), and single photon emission computed tomography (SPECT) were used to assess tumor response.
  • RESULTS: High-intensity focused ultrasound ablation guided by real-time US was performed.
  • Survival rates at 1, 2, 3, 4, and 5 years were 93.3%, 82.4%, 75.0%, 63.7%, and 63.7%, respectively, in the patients with stage IIb cancer and 79.2%, 42.2%, 21.1%, 15.8%, and 15.8%, respectively, in those with stage III disease.
  • Among the patients with stage IIb disease, long-term survival rates were substantially improved in the 30 patients who received the full treatment-that is, complete high-intensity focused ultrasound and full cycles of chemotherapy-compared with the survival rates for the 24 patients who did not finish the chemotherapy cycles and the six patients who underwent partial ablation only.
  • [MeSH-major] Bone Neoplasms / therapy. Ultrasonic Therapy / methods. Ultrasonography, Interventional
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Antineoplastic Agents / administration & dosage. Chemotherapy, Adjuvant. Child. Child, Preschool. Disease Progression. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Staging. Proportional Hazards Models. Prospective Studies. Survival Rate. Tomography, Emission-Computed, Single-Photon. Tomography, X-Ray Computed. Treatment Outcome

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  • [Copyright] Copyright RSNA, 2010
  • (PMID = 20501734.001).
  • [ISSN] 1527-1315
  • [Journal-full-title] Radiology
  • [ISO-abbreviation] Radiology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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24. Tang X, Guo W, Yang R: [Segmental allograft reconstruction in skeletal defect after limb tumor resection]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2006 Oct;20(10):985-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The bone involvements were observed in 16 patients with osteosarcoma, 4 patients with parosteal osteosarcoma, 5 patients with Ewing sarcoma, and 3 patients with soft tissue sarcoma.
  • The patients with osteosarcoma or Ewing sarcoma received the standard chemotherapy before and after operation.
  • Of the 28 patients, 3 developed nonunion of the allograft-host junction accompanied by severe resorption and 2 developed deep infection.
  • [MeSH-major] Bone Neoplasms. Bone Transplantation. Osteosarcoma. Reconstructive Surgical Procedures / methods

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  • (PMID = 17140069.001).
  • [ISSN] 1002-1892
  • [Journal-full-title] Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery
  • [ISO-abbreviation] Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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25. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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