المؤلفون: Campanacci, Domenico Andrea, Scanferla, Roberto, Marsico, Mariagrazia, Scolari, Federico, Scoccianti, Guido, Beltrami, Giovanni, Delcroix, Luca, Innocenti, Marco, Capanna, Rodolfo

المصدر: Clinical Orthopaedics & Related Research ; ISSN 0009-921X 1528-1132

الوصف: Background Reconstruction with vascularized fibula grafts (VFG) after intercalary resection of sarcoma may offer longevity by providing early graft-host union and fracture healing. The ability of the fibula to hypertrophy under mechanical stress, as well as vascularized bone in the area, may also be advantageous, given that soft tissues may be compromised because of resection, chemotherapy, or radiation therapy. VFG with a massive allograft combines the primary mechanical stability of the graft with the biological potential of the vascularized fibula; however, complications and the durability of this combined reconstruction are not well described. Questions/purposes (1) What was the proportion of complications after reconstruction with VFG, with or without allografts? (2) What was the functional result after surgical treatment as assessed by the Musculoskeletal Tumor Society (MSTS) score? (3) What was the survivorship of these grafts free from revision and graft removal? Methods Between 1988 and 2021, 219 patients were treated at our institution for a primary malignant or aggressive benign bone tumor of the tibia with en bloc resection. Of those, 54% (119 of 219) had proximal tibial tumors with epiphyseal involvement and were treated with either intra-articular resection and reconstruction with an osteoarticular allograft, allograft-prosthesis composite (APC), or modular prosthesis according to age, diagnosis, and preoperative or postoperative radiotherapy. Nine percent (20) of patients had distal tibial tumors that were treated with intra-articular resection and reconstruction with ankle arthrodesis using allogenic or autologous grafts, and 0.5% (1 patient) underwent total tibial resection for extensive tumoral involvement of the tibia and reconstruction with an APC. Thirty-six percent (79) of patients had a metadiaphyseal bone tumor of the tibia and were treated with intercalary joint-sparing resection. We routinely use reconstruction with VFG after intercalary tibial resection for primary malignant or ...

الإتاحة: https://doi.org/10.1097/corr.0000000000003007Test

المؤلفون: Campanacci, Domenico Andrea, Scanferla, Roberto, Innocenti, Matteo, Muratori, Francesco, Puccini, Serena, Scoccianti, Guido, Beltrami, Giovanni, Capanna, Rodolfo, Innocenti, Marco

المصدر: Clinical Orthopaedics & Related Research ; volume 481, issue 11, page 2185-2197 ; ISSN 0009-921X 1528-1132

الوصف: Background A vascularized fibula graft (VFG) is the vascular autograft most frequently used to restore large segmental long bone defects, particularly in the upper limb. Because the use of a vascularized fibula involves an operation in an uninvolved extremity with potential morbidity, it is important to document that this type of reconstruction is successful in restoring function to the humerus. However, the long-term results of VFG after intercalary resection of the humeral diaphysis for bone tumors are still unknown. Questions/purposes (1) What was the complication rate of reconstruction? (2) What was the functional result after surgical treatment, as assessed by the Musculoskeletal Tumor Society (MSTS) score, the American Shoulder and Elbow Society (ASES) score, and Constant score? (3) What was the survivorship of these grafts free from revision and graft removal at 5, 10, and 15 years? Methods Between 1987 and 2021, 127 patients were treated at our institution with en bloc resection for a primary malignant or an aggressive benign bone tumor of the humerus; we excluded patients treated with extra-articular resection or amputation. Of those, 14% (18 of 127) were treated with intercalary resection of the humeral diaphysis for primary bone tumors and reconstruction with VFG, with or without a bulk allograft, and were analyzed in this retrospective study. Generally, our indications for reconstruction with VFG are intercalary resection of the humerus for primary malignant or aggressive benign bone tumors in patients with long life expectancy and high functional demands, in whom adequate bone stock of the proximal and distal epiphysis can be preserved. In 13 patients, VFG was used alone, whereas in five patients, a massive allograft was used. Our policy was to use VFG combined with a massive allograft in patients undergoing juxta-articular joint-sparing resections in which proximal osteotomy was performed close to the anatomic neck of the humerus to obtain more stable fixation and better tendinous ...

الإتاحة: https://doi.org/10.1097/corr.0000000000002739Test

المؤلفون: Scanferla, Roberto, Scolari, Federico, Muratori, Francesco, Tamburini, Angela, Delcroix, Luca, Scoccianti, Guido, Beltrami, Giovanni, Innocenti, Marco, Campanacci, Domenico Andrea

المصدر: Cancers; May2024, Vol. 16 Issue 9, p1672, 13p

مصطلحات موضوعية: PREVENTION of surgical complications, TIBIA surgery, OSTEOSARCOMA, LIFE expectancy, HOMOGRAFTS, TREATMENT effectiveness, DESCRIPTIVE statistics, KNEE joint, BONE grafting, LIMB salvage, REOPERATION, PLASTIC surgery, SURVIVAL analysis (Biometry)

مستخلص: Simple Summary: Osteosarcoma most frequently affects the metaphyseal region of the distal femur and proximal tibia; in around 20% of patients, the epiphyseal bone is not affected and an intercalary joint-sparing resection can be safely performed, preserving the native joint and ligament insertions. In young patients, according to their high functional expectations and potential long-life expectancy, the objective of reconstruction is to restore lower limb function with a low risk of reoperation and implant removal at long-term follow-up. VFG combined with massive allograft is one of the possible reconstructive options after intercalary resection around the knee. In the present study, we aimed to investigate the long-term results of this technique in patients treated for osteosarcoma around the knee with a joint-sparing resection. (1) Background: We aim to address the following questions. What was the complication rate of vascularized fibula graft (VFG) combined with massive allograft in patients treated with joint-sparing resection around the knee for a high-grade osteosarcoma? What was the long-term survivorship of VFG free from revision and graft removal? What were the functional results as assessed by the Musculoskeletal Tumor Society (MSTS) score? (2) Methods: 39 patients treated in our unit for osteosarcoma around the knee with intercalary resection and reconstruction with VFG combined with massive allograft were included; 26 patients underwent intercalary tibial resection, while 13 underwent intercalary femoral resection. (3) Results: Mean Follow-Up was 205 months (28 to 424). Complications that required surgery were assessed in requiring surgical revision in 19 patients (49%) after a mean of 31 months (0 to 107), while VFG removal was necessary in three patients (8%). The revision-free survival of the reconstructions was 59% at 5 years and 50% at 10 to 30 years. The overall survival of the reconstructions was 95% at 5 to 15 years and 89% at 20 to 30 years. The mean MSTS score was 29.3 (23 to 30). (4) Conclusions: VFG represents an effective reconstructive option after joint-sparing intercalary resection around the knee for osteosarcoma. [ABSTRACT FROM AUTHOR]

: Copyright of Cancers is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Rijs, Zeger, Weekhout, Amber, Lozano-Calderon, Santiago A., Groot, Olivier Q., Berner, Emily, Merchan, Nelson, Yeung, Caleb M., Oliveira, Vsania, Bianchi, Giuseppe, Staals, Eric, Lana, Debora, Donati, Davide, Segal, Ortal, Marone, Stefano, Piana, Raimondo, De Meo, Simone, Pellegrino, Pietro, Ratto, Nicola, Zoccali, Carmine, Scorianz, Maurizio, Tomai, Cecilia, Scoccianti, Guido, Campanacci, Domenico Andrea, Andreani, Lorenzo, de Franco, Silvia, Boffano, Michele, Cosker, Thomas, Sethurajah, Varunprasanth, Pensado, Manuel Peleteiro, Ruiz, Irene Barrientos, Moreno, Esperanza Holgado, Ortiz-Cruz, Eduardo Jose, van de Sande, Michiel

المصدر: Scientific Reports ; volume 12, issue 1 ; ISSN 2045-2322

مصطلحات موضوعية: Multidisciplinary

الوصف: Carbon-fiber (CF) plates are a promising alternative to metal plates. However, reported experience in orthopaedic oncology remains limited. The aim of this study was to identify complications of patients with bone tumors treated with CF plates. Between February 2015 and May 2021, 13 centers retrospectively registered patients with bone tumors that were reconstructed using CF plates. Complications were identified, and timing and etiology of complications were noted. Similar complications were tabulated and classified based on mechanical, non-mechanical and paediatric complications. Mechanical complications included: (1) aseptic loosening or graft-host non-union, and (2) structural complications. Non-mechanical complications included: (3) soft tissue complications, (4) infection and (5) tumor progression. Specific paediatric complications included (6) growth arrest resulting in longitudinal or angular deformity. Ninety-six patients were included with a median follow-up time of 35 months. In total, 22 (23%) patients had complications. Mechanical complications included: 1 (1%) aseptic loosening, 2 (2%) non-unions, and 7 (7%) structural complications. Non-mechanical complications included 1 (1%) soft tissue complication, 4 (4%) infections and 5 (5%) tumor progressions. Paediatric complications occurred in 2 (2%) patients. This study suggests CF plates are safe to use in demanding reconstructions after bone tumor resections, presenting a seemingly low complication profile.

الإتاحة: https://doi.org/10.1038/s41598-022-23519-9Test
https://www.nature.com/articles/s41598-022-23519-9.pdfTest
https://www.nature.com/articles/s41598-022-23519-9Test

المؤلفون: Scoccianti, Guido¹ (AUTHOR) roberto.scanferla@unifi.it, Innocenti, Matteo² (AUTHOR) matteo.innocenti@unifi.it, Scanferla, Roberto¹ (AUTHOR) muratorif@aou-careggi.toscana.it, Scolari, Federico³ (AUTHOR) federico.scolari@unifi.it, Muratori, Francesco¹ (AUTHOR) domenicoandrea.campanacci@unifi.it, Ungar, Andrea⁴ (AUTHOR) andrea.ungar@unifi.it, Rostagno, Carlo⁵ (AUTHOR) carlo.rostagno@unifi.it, Campanacci, Domenico Andrea¹ (AUTHOR)

المصدر: Journal of Clinical Medicine. Dec2023, Vol. 12 Issue 24, p7740. 11p.

مصطلحات موضوعية: *OCTOGENARIANS, *OLDER patients, *ARTHROPLASTY, *PERIPROSTHETIC fractures, *EARLY death

مستخلص: Few data are available about results after procedures of resection and megaprosthesis at the hip in very elderly patients. The aim of our study was to ascertain survival and complications in patients aged 80 or older undergoing these major orthopedic procedures. A consecutive series of 27 procedures in 26 patients aged 80–93 years was evaluated. In total, 15 procedures were performed due to oncological diseases, 6 were performed following joint arthroplasty failures or periprosthetic fractures, and 6 were performed after trauma or trauma sequelae. Survival of the patients ranged from 0 to 122 months. Overall survival was 56% at 3 years, 24% at 5 years, and 16% at 8 years. An early postoperative death during the first 3 months occurred in five patients (18.5%). The only preoperative parameter negatively affecting survival was preoperative hemoglobin lower than 11 g/dL. Local complications were similar to reported rates in all-age patients' series. In our experience, resection and megaprosthetic reconstruction can also be a valid choice in very elderly patients, with 56% of patients living more than two years from surgery and 24% more than five. Nevertheless, early postoperative deaths are frequent. A multidisciplinary evaluation of frailty of the patient must be accomplished, and patients and relatives must be informed about the risks of the procedure. [ABSTRACT FROM AUTHOR]

المؤلفون: Cuomo, Pierluigi, Scoccianti, Guido, Schiavo, Alberto, Tortolini, Valentina, Wigley, Catrin, Muratori, Francesco, Matera, Davide, Kukushkina, Mariia, Funovics, Philipp Theodor, Lingitz, Marie-Theres, Windhager, Reinhard, Dijkstra, Sander, Jasper, Jorrit, Müller, Daniel A, Kaiser, Dominik, Perlaky, Tamás, Leithner, Andreas, Smolle, Maria Anna, Campanacci, Domenico Andrea

المصدر: Cuomo, Pierluigi; Scoccianti, Guido; Schiavo, Alberto; Tortolini, Valentina; Wigley, Catrin; Muratori, Francesco; Matera, Davide; Kukushkina, Mariia; Funovics, Philipp Theodor; Lingitz, Marie-Theres; Windhager, Reinhard; Dijkstra, Sander; Jasper, Jorrit; Müller, Daniel A; Kaiser, Dominik; Perlaky, Tamás; Leithner, Andreas; Smolle, Maria Anna; Campanacci, Domenico Andrea (2021). Extra-abdominal desmoid tumor fibromatosis: a multicenter EMSOS study. BMC Cancer, 21:437-443.

مصطلحات موضوعية: Balgrist University Hospital, Swiss Spinal Cord Injury Center, 610 Medicine & health

الوصف: BACKGROUND Extra-abdominal desmoid tumor fibromatosis (DTF) is a rare, locally aggressive soft tissue tumour. The best treatment modality for this patient cohort is still object of debate. QUESTIONS/PURPOSE This paper aimed to (1) to compare the outcomes of DTF after different treatment modalities, (2) to assess prognostic factors for recurrence following surgical excision, and (3) to assess prognostic factors for progression during observation. METHODS This was a retrospective multicenter study under the patronage of the European Musculoskeletal Oncology Society (EMSOS). All seven centres involved were tertiary referral centres for soft tissue tumours. Baseline demographic data was collected for all patients as well as data on the diagnosis, tumour characteristics, clinical features, treatment modalities and whether they had any predisposing factors for DTF. RESULTS Three hundred eighty-eight patients (240 female, 140 male) with a mean age of 37.6 (±18.8 SD, range: 3-85) were included in the study. Two hundred fifty-seven patients (66%) underwent surgical excision of ADF, 70 patients (18%) were observed without therapy, the residual patients had different conservative treatments. There were no significant differences in terms of tumour recurrence or progression between the different treatment groups. After surgical excision, younger age, recurrent disease and larger tumour size were risk factors for recurrence, while tumours around the shoulder girdle and painful lesions were at risk of progression in the observational group. CONCLUSION Local recurrence rate after surgery was similar to progression rates under observation. Hence, observation in DTF seems to be justified, considering surgery in case of dimensional progression in 2 consecutive controls (3 and 6 months) and in painful lesions, with particular attention to lesions around the shoulder girdle.

وصف الملف: application/pdf

العلاقة: https://www.zora.uzh.ch/id/eprint/212370/1/s12885-021-08189-6.pdfTest; info:pmid/33879110; urn:issn:1471-2407

الإتاحة: https://doi.org/10.5167/uzh-21237010.1186/s12885-021-08189-6Test
https://www.zora.uzh.ch/id/eprint/212370Test/
https://www.zora.uzh.ch/id/eprint/212370/1/s12885-021-08189-6.pdfTest

المؤلفون: Innocenti, Matteo, Muratori, Francesco, Foschi, Lorenzo, Bartolini, Saverio, Scorianz, Maurizio, Scoccianti, Guido, Campanacci, Domenico Andrea

المساهمون: Università degli Studi di Firenze

المصدر: Archives of Orthopaedic and Trauma Surgery ; volume 143, issue 2, page 763-771 ; ISSN 1434-3916

مصطلحات موضوعية: Orthopedics and Sports Medicine, General Medicine, Surgery

الوصف: Introduction Megaprosthesis represent the most commonly used limb salvage method after musculoskeletal tumor resections. Nevertheless, they are burdened by high complication rate, requiring several surgical revisions and eventually limb amputation. The aims of this study were to evaluate the effect of rescuing the limb with subsequent revisions on complication rates (a), incidence of amputations (b), and whether complications reduce functional outcome after the first surgical revision (c). Materials and methods We retrospectively reviewed 444 lower limb megaprosthesis implanted for primary musculoskeletal tumors or metastatic lesions, from February 2000 to November 2017. 59 patients received at least one revision megaprosthesis surgery. MSTS score was used to assess final functional results. Complication-revision-amputation free survival rates were calculated both at 5 and 10 years of follow-up. Results Complication free survival, revision free survival and amputation free survival at 10 years were 47% and 53%, 61% and 67%, 90% and 86% among all 444 patients and the group of 59 revised patients, respectively. The incidence of further complications after the first complication was 26% in the group treated with no subsequent revision surgeries and 51% in the group with at least one revision surgery. We found a trend of inverse linear relationship between the number of complications needing subsequent revision surgeries and the final MSTS. Conclusion The number of further revision surgeries after limb salvage with megaprosthesis increases the incidence of complications. Repeated surgical revisions, in particular after infection, increase the amputation rate. The most frequent causes of failure were structural failures and infections. MSTS score was superior for patients undergoing limb salvage than amputees. However, MSTS progressively decreased with multiple revisions becoming inferior to the functional score of an amputated patient.

الإتاحة: https://doi.org/10.1007/s00402-021-04165-8Test

المؤلفون: Scoccianti, Guido, Scanferla, Roberto, Scorianz, Maurizio, Frenos, Filippo, Sacchetti, Federico, Muratori, Francesco, Campanacci, Domenico A.

المصدر: Journal of Surgical Oncology; Sep2023, Vol. 128 Issue 4, p653-659, 7p

المؤلفون: Sacchetti, Federico, Alsina, Andac Celasun, Muratori, Francesco, Scoccianti, Guido, Neri, Elisabetta, Kaya, Huseyin, Sabah, Dundar, Capanna, Rodolfo, Campanacci, Domenico Andrea

المصدر: Journal of Orthopaedics; Aug2023, Vol. 42, p74-79, 6p

مصطلحات موضوعية: CANCER chemotherapy, MULTIVARIATE analysis, RETROSPECTIVE studies, METASTASIS, TUMOR classification, SURGICAL margin, SOFT tissue tumors, KAPLAN-Meier estimator, DESCRIPTIVE statistics, RADIOTHERAPY, CANCER patient medical care, OVERALL survival

مستخلص: Synovial Sarcoma (SS) is a rare soft tissue sarcoma. Mean time to get a SS diagnosis from the onset of symptoms is 10 years, furthermore, SS is associated with late metastasis. Surgery is the main treatment option, whose quality deeply affects SS outcomes, and it can be associated to preoperative or post-operative radiotherapy. Chemotherapy is considered very effective in Children, while in adults its efficacy is still under debate. The aim of this study was to investigate the oncologic results in SS treatment and to identify the risk factors for local and systemic control of the disease. From 1994 to 2018, 211 patients affected by SS were treated in 3 Referral Centres of Orthopaedic Oncology. One hundred seventy-seven patients were included in the study, the median follow-up length was 96 months (5–374). Overall Survival on the Kaplan Meier Analyses was 80%, 70% and 56% at 5, 10 and 20 years. In multivariate analyses, OS correlated with tumour size and negative surgical margins. Chemotherapy use wasn't associated with better survival although patients who underwent CT had bigger and more aggressive tumours. Our findings suggests that surgery with negative margins is the most important factor in Synovial Sarcoma. Adjuvant treatments as chemotherapy and radiation therapy didn't change the disease's course. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Orthopaedics is the property of Professor PK Surendran Memorial Education Foundation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Palmerini, Emanuela, Ruggieri, Pietro, Angelini, Andrea, Boriani, Stefano, Campanacci, Domenico, Milano, Giuseppe M., Cesari, Marilena, Paioli, Anna, Longhi, Alessandra, Abate, Massimo E., Scoccianti, Guido, Terzi, Silvia, Trovarelli, Giulia, Franchi, Alessandro, Picci, Piero, Ferrari, Stefano, Leopardi, Martina Piccinni, Pierini, Michela

المساهمون: Palmerini, Emanuela, Ruggieri, Pietro, Angelini, Andrea, Boriani, Stefano, Campanacci, Domenico, Milano, Giuseppe M., Cesari, Marilena, Paioli, Anna, Longhi, Alessandra, Abate, Massimo E., Scoccianti, Guido, Terzi, Silvia, Trovarelli, Giulia, Franchi, Alessandro, Picci, Piero, Ferrari, Stefano, Leopardi, Martina Piccinni, Pierini, Michela

مصطلحات موضوعية: Aneurysmal bone cyst, bone tumor, denosumab, receptor activator of nuclear factor-kappa B ligand, Adolescent, Adult, Bone Cysts, Aneurysmal, Bone Density Conservation Agent, Female, Follow-Up Studie, Human, Male, Retrospective Studie, Treatment Outcome, Young Adult, Medicine (all)

الوصف: PURPOSE:: Aneurysmal bone cyst (ABC) is a rare skeletal tumor usually treated with surgery/embolization. We hypothesized that owing to similarities with giant cell tumor of bone (GCTB), denosumab was active also in ABC. METHODS:: In this observational study, a retrospective analysis of ABC patients treated with denosumab was performed. Patients underwent radiologic disease assessment every 3 months. Symptoms and adverse events were noted. RESULTS:: Nine patients were identified (6 male, 3 female), with a median age of 17 years (range 14-42 years). Primary sites were 6 spine-pelvis, 1 ulna, 1 tibia, and 1 humerus. Patients were followed for a median time of 23 months (range 3-55 months). Patients received a median of 8 denosumab administrations (range 3-61). All symptomatic patients had pain relief and 1 had paresthesia improvement. Signs of denosumab activity were observed after 3 to 6 months of administration: bone formation by computed tomography scan was demonstrated in all patients and magnetic resonance imaging gadolinium contrast media decrease was observed in 7/9 patients. Adverse events were negligible. At last follow-up, all patients were progression-free: 5 still on denosumab treatment, 2 off denosumab were disease-free 11 and 17 months after surgery, and the last 2 patients reported no progression 12 and 24 months after denosumab interruption and no surgery. CONCLUSIONS:: Denosumab has substantial activity in ABCs, with favorable toxicity profile. We strongly support the use of surgery and/or embolization for the treatment of ABC, but denosumab could have a role as a therapeutic option in patients with uncontrollable, locally destructive, or recurrent disease.

وصف الملف: STAMPA

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/30086700; info:eu-repo/semantics/altIdentifier/wos/WOS:000452608900005; volume:104; issue:5; firstpage:344; lastpage:351; numberofpages:8; journal:TUMORI; http://hdl.handle.net/11568/939432Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85056588917

الإتاحة: https://doi.org/10.1177/0300891618784808Test
http://hdl.handle.net/11568/939432Test