Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Highlights from the First Combined 2011 Meeting of the Musculoskeletal Tumor Society and Connective Tissue Oncology Society 14 articles

Articles

Lipid-functionalized Dextran Nanosystems to Overcome Multidrug Resistance in Cancer: A Pilot Study

Eisuke Kobayashi MD, PhD, Arun K. Iyer PhD, Francis J. Hornicek MD, PhD, Mansoor M. Amiji PhD, Zhenfeng Duan MD, PhD

The toxicity of anticancer agents and the difficulty in delivering drugs selectively to tumor cells pose a challenge in overcoming multidrug resistance (MDR). Recently, nanotechnology has emerged as a powerful tool in addressing some of the barriers to drug delivery, including MDR in cancer, by utilizing alternate routes of cellular entry and targeted delivery of drugs and genes. However, it is unclear whether doxorubicin (Dox) can be delivered by nanotechnologic approaches.

Surgery Quality and Tumor Status Impact on Survival and Local Control of Resectable Liposarcomas of Extremities or the Trunk Wall

Piotr Rutkowski MD, PhD, Sławomir Trepka MD, PhD, Konrad Ptaszynski MD, PhD, Milena Kołodziejczyk MD, PhD

The 5-year survival rates for localized liposarcomas reportedly vary from 75% to 91% with histologic grade as the most important prognostic factor. However, it is unclear which other factors, including the initial surgery quality and recurrent tumors, influence survival in localized liposarcomas (LPS).

Does Combined Open and Arthroscopic Synovectomy for Diffuse PVNS of the Knee Improve Recurrence Rates?

Matthew W. Colman MD, Jason Ye MD, Kurt R. Weiss, Mark A. Goodman MD, Richard L. McGough MD

Diffuse-type pigmented villonodular synovitis (PVNS) has a high local recurrence rate and as such can lead to erosive destruction of the involved joint. Multiple surgical modalities exist, but it is unknown which technique best minimizes local recurrence and surgical morbidity.

Treating Metastatic Disease: Which Survival Model Is Best Suited for the Clinic?

Jonathan Agner Forsberg MD, Daniel Sjoberg MA, Qing-Rong Chen PhD, Andrew Vickers PhD, John H. Healey MD

To avoid complications associated with under- or overtreatment of patients with skeletal metastases, doctors need accurate survival estimates. Unfortunately, prognostic models for patients with skeletal metastases of the extremities are lacking, and physician-based estimates are generally inaccurate.

Primary Osseous Tumors of the Hindfoot: Why the Delay in Diagnosis and Should We Be Concerned?

Peter S. Young MRCS, Stuart W. Bell MRCS, MRCP, Elaine M. MacDuff BSc, MBChB, FRCPath, Ashish Mahendra FRCS Tr & Orth

Bony tumors of the foot account for approximately 3% of all osseous tumors. Diagnosis is frequently delayed as a result of lack of clinician familiarity and as a result of their rarity. The reasons for the delays, however, are unclear.

Adult Soft Tissue Sarcoma Local Recurrence After Adjuvant Treatment Without Resection of Core Needle Biopsy Tract

Odion Binitie MD, Shawn Tejiram MD, Sheila Conway MD, David Cheong MD, H. Thomas Temple MD, G. Douglas Letson MD

Core needle biopsies of sarcomas allow a diagnosis in a high percentage of patients with few complications. However, it is unclear whether the tract needs to be excised to prevent recurrences.

Lymphadenectomy and Histologic Subtype Affect Overall Survival of Soft Tissue Sarcoma Patients With Nodal Metastases

Chigusa Sawamura MD, MPH, Seiichi Matsumoto MD, PhD, Takashi Shimoji MD, PhD, Keisuke Ae MD, PhD, Atsushi Okawa MD, PhD

Lymph node metastases in patients with soft tissue sarcomas are rare and these metastases are frequently associated with certain histologic subtypes. The survival is believed to be poor if lymph node metastases occur and the potential benefit of lymphadenectomy is unclear.

A Novel Imaging System Permits Real-time in Vivo Tumor Bed Assessment After Resection of Naturally Occurring Sarcomas in Dogs

William C. Eward DVM, MD, Jeffrey K. Mito MD, PhD, Cindy A. Eward DVM, Jessica E. Carter, Jorge M. Ferrer PhD, David G. Kirsch MD, PhD, Brian E. Brigman MD, PhD

Treatment of soft tissue sarcoma (STS) includes complete tumor excision. However, in some patients, residual sarcoma cells remain in the tumor bed. We previously described a novel hand-held imaging device prototype that uses molecular imaging to detect microscopic residual cancer in mice during surgery.

Using the CUSUM Test to Control the Proportion of Inadequate Open Biopsies of Musculoskeletal Tumors

David J. Biau MD, PhD, Kurt R. Weiss MD, MSc, Rej S. Bhumbra PhD, FRCS (Tr & Orth), Darin Davidson MD, MSc, Chris Brown MD, PhD, Jay S. Wunder MD, MSc, Peter C. Ferguson MD, MSc

Biopsies of musculoskeletal tumors lead to alterations in treatment in almost 20% of cases. Control charts are useful to ensure that a process is operating at a predetermined level of performance, although their use has not been demonstrated in assessing the adequacy of musculoskeletal biopsies.

Haptic Robot-assisted Surgery Improves Accuracy of Wide Resection of Bone Tumors: A Pilot Study

Fazel Khan MD, Andrew Pearle MD, Christopher Lightcap PhD, Patrick J. Boland MD, John H. Healey MD

Accurate reproduction of the preoperative plan at the time of surgery is critical for wide resection of primary bone tumors. Robotic technology can potentially help the surgeon reproduce a given preoperative plan, but yielding control of cutting instruments to a robot introduces potentially serious complications. We developed a novel passive (“haptics”) robot-assisted resection technique for primary bone sarcomas that takes advantage of robotic accuracy while still leaving control of the cutting instrument in the hands of the surgeon.

Staples Equal Sutures for Skin Closure After Soft Tissue Tumor Resection

David C. Moore BA, Meredith H. Sellers BA, Kristin R. Archer PhD, DPT, Herbert S. Schwartz MD, Ginger E. Holt MD

Wound closure accounts for a relatively constant portion of the time required to complete a surgical case. Both longer closure times and wound infections contribute to higher medical costs and patient morbidity.

Compressive Osseointegration Into a Custom Acetabular Implant Masquerading as Tumor Recurrence: A Case Report

Adam J. Schwartz MD, Christopher P. Beauchamp MD

Compressive osseointegration is a durable method of method of achieving fixation in long-bone reconstruction, and radiographic findings are well described. The radiographic appearance of integration into the pelvis is poorly defined in the available literature.