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A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Bone and Soft Tissue Oncology".

Deadline for manuscript submissions: closed (15 June 2023) | Viewed by 21258

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Special Issue Editors

Dr. Andreas F. Mavrogenis

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First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Interests: orthopaedics; oncology; infections; traumatology

Dr. Costantino Errani

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III Clinica di Ortopedia e Traumatologia, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
Interests: bone tumors; soft tissue tumors; bone sarcomas; soft tissue sarcomas; bone metastases; limb salvage surgery
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Dr. Shinji Tsukamoto

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Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
Interests: orthopaedics; oncology; infections; traumatology

Special Issue Information

Dear Colleagues,

Musculoskeletal Oncology specializes in the diagnosis and treatment of benign and malignant bone and soft tissue tumors of children and adults, as well as the diagnosis, treatment, and palliative care of those with metastatic bone disease. Musculoskeletal oncologists including medical and surgeons work in concert with experts from musculoskeletal radiology, pathology, medical and pediatric oncology, radiotherapy, and surgery to care for patients with musculoskeletal tumors.

Recently, surgical treatments, adjuvant and neo-adjuvant therapies have expanded beyond their traditional indications and uses. Genetic profiling of tumors has enabled better understanding of the biology and the dynamic evolution of the tumors and patients’ responses to treatments. Clinical trials and meta-analyses have provided useful insights for the approach, diagnosis, treatments and prognosis of these patients. Suitable algorithms are currently available for the diagnosis and management of the patients with musculoskeletal tumors. Definitely, all of the above are multidisciplinary with input from several specialists such as orthopaedic oncology, plastics and vascular surgeons, medical oncology, radiation oncology, radiology and pathology physicians.

This Special Issue aims to share knowledge and improve care for our community of bone and soft tissue tumor patients. In this context, Current Oncology will be honored and grateful to receive articles on how tumor surgeons, diagnostic and interventional radiologists, medical oncologists and pathologists approach and manage these patients. This Special Issue will highlight the current state-of-the-art in the management of patients with musculoskeletal tumors, and will provide future prospects for improving our understanding of the tumors biology and optimizing patient care.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: primary and metastatic bone tumors and hematological malignancies, diagnosis, biopsy principles, imaging, surgical treatments and biomechanics (novelties, implants, reconstructions), medical treatments (adjuvants and neo-adjuvants), targeted treatments, outcome (survival, metastasis, local recurrence), prognosis. Please feel free to share your experiences and submit your article in the “Musculoskeletal Oncology” topical collection section until 15th of June 2023!

We look forward to receiving your contributions.

Dr. Andreas F. Mavrogenis
Dr. Costantino Errani
Dr. Shinji Tsukamoto
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

sarcomas
metastatic bone disease
hematological malignancies
biopsy
imaging
surgery
biomechanics
chemotherapy
radiotherapy
targeted treatments
outcome
prognosis

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Published Papers (8 papers)

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21 pages, 2749 KiB

Open AccessArticle

Investigation of the Incidence and Geographic Distribution of Bone and Soft Tissue Sarcomas in Canada: A National Population-Based Study

by Badria Alkazemi, Feras M. Ghazawi, François Lagacé, Vladimir Nechaev, Andrei Zubarev and Ivan V. Litvinov

Curr. Oncol. 2023, 30(6), 5631-5651; https://doi.org/10.3390/curroncol30060424 - 9 Jun 2023

Cited by 2 | Viewed by 2144

Abstract

Sarcomas are a heterogeneous group of mesenchymal malignancies with various genetic and environmental risk factors. This study analyzed the epidemiology of sarcomas to gain insight into the incidence and mortality rates of these cancers in Canada, as well as to elucidate their potential environmental risk factors. Data for this study were obtained from le Registre Québécois du Cancer (LRQC) and from the Canadian Cancer Registry (CCR) for the period from 1992 to 2010. Mortality data were obtained from the Canadian Vital Statistics (CVS) database for the period from 1992 to 2010 using the International Classification of Diseases for Oncology, ICD-O-3, ICD-9, or ICD-10 codes, for all subtypes of sarcomas. We found that the overall sarcoma incidence in Canada decreased during the study period. However, there were select subtypes with increasing incidence. Peripherally located sarcomas were found to have lower mortality rates compared to axially located sarcomas, as expected. Clustering of Kaposi sarcoma cases in self-identified LGBTQ+ communities and in postal codes with a higher proportion of African-Canadian and Hispanic populations was observed. Forward Sortation Area (FSA) postal codes with a lower socioeconomic status also had higher Kaposi sarcoma incidence rates. Full article

(This article belongs to the Special Issue What’s New in Musculoskeletal Oncology?)

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12 pages, 2418 KiB

Open AccessArticle

Clinical Rationale of Using Steerable Technologies for Radiofrequency Ablation Followed by Cavity Creation and Cement Augmentation in the Treatment of Painful Spinal Metastases

by Claudio Pusceddu, Salvatore Marsico, Daniele Derudas, Nicola Ballicu, Luca Melis, Stefano Zedda, Carlo De Felice, Alessandro Calabrese, Domiziana Santucci and Eliodoro Faiella

Curr. Oncol. 2023, 30(4), 4257-4268; https://doi.org/10.3390/curroncol30040324 - 19 Apr 2023

Cited by 3 | Viewed by 1897

Abstract

(1) Background: Cement distribution after radiofrequency ablation of spinal metastases can be unpredictable due to various tumor factors, and vertebral augmentation requires advanced devices to prevent cement leakage and achieve satisfactory filling. The purpose of this study is to evaluate the safety and efficacy of a platform of steerable technologies with an articulating radiofrequency ablation (RFA) probe and targeted cavity creation before vertebral augmentation in the treatment of painful spinal metastases. (2) Methods: Sixteen patients (mean age, 67 years) underwent RFA in conjunction with vertebral augmentation after the creation of a targeted balloon cavity for metastatic spinal disease and were followed up to 6 months. Pain and functional mobility were assessed before treatment and postoperatively using the Visual Analogue Score (VAS) and Functional Mobility Scale (FMS). Complications, predictability of cement distribution, anatomical restoration, and local recurrence were collected. Technical success was defined as successful intraoperative ablation and predictable cement distribution after cavity creation without major complications. (3) Results: Sixteen patients with 21 lesions were treated for tumors involving the thoracolumbar spine. All treatments were technically successful and were followed by targeted cavity creation and vertebral augmentation. A statistically significant reduction in median VAS score was observed before treatment and 1 week after RFA treatment (p < 0.001). A total of six of the seven patients who reported limited painful ambulation before treatment reported normal ambulation 1 month after treatment, while the remaining patient reported no improvement. Patients who reported wheelchair use before treatment improved to normal ambulation (four/eight) or limited painful ambulation (four/eight). The improvement in mobility before and after treatment was statistically significant (p = 0.002). Technical success was achieved in all the combined procedures. (4) Conclusions: The combined treatment of RFA and vertebral augmentation with a steerable platform that allows the creation of a targeted cavity prior to cement injection proved to be a safe and effective procedure in our patient sample, resulting in improved quality of life as assessed by the Visual Analogue Score (VAS) and Functional Mobility Scale (FMS). Full article

(This article belongs to the Special Issue What’s New in Musculoskeletal Oncology?)

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11 pages, 3218 KiB

Open AccessArticle

Injectable Synthetic Beta-Tricalcium Phosphate/Calcium Sulfate (GeneX) for the Management of Contained Defects Following Curettage of Benign Bone Tumours

by Nima Razii, Laura M. Docherty, Mansur Halai, Ashish Mahendra and Sanjay Gupta

Curr. Oncol. 2023, 30(4), 3697-3707; https://doi.org/10.3390/curroncol30040281 - 27 Mar 2023

Viewed by 3300

Abstract

Benign and low-grade malignant bone tumours are often treated with curettage and filling of the resultant defect using any of a number of materials, including autologous bone grafts, allografts, or synthetic materials. The objective of this study was to report our experience using a synthetic bone graft substitute in these patients. Ten consecutive cases (four males, six females; mean age, 36 years) of benign bone tumours were treated surgically at a tertiary musculoskeletal oncology centre, between 2019 and 2021. Following curettage, the contained defects were managed with injectable beta-tricalcium phosphate/calcium sulfate (GeneX; Biocomposites Ltd., Keele, UK). The desired outcomes were early restoration of function and radiographic evidence of healing. No other graft materials were used in any of the patients. The mean follow-up was 24 months (range, 20–30 months). All patients in this series (100%) demonstrated radiographic evidence of healing and resumed their daily living activities. There were no tumour recurrences and no complications were encountered with the use of GeneX. In patients with contained defects following curettage of benign bone tumours, we found GeneX to be a safe and effective filling agent. These findings contrast with some existing studies that have reported local complications with the use of injectable beta-tricalcium phosphate/calcium sulfate. Full article

(This article belongs to the Special Issue What’s New in Musculoskeletal Oncology?)

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9 pages, 846 KiB

Open AccessArticle

Functional Outcomes and Shoulder Instability in Reconstruction of Proximal Humerus Metastases

by Alessandro El Motassime, Cesare Meschini, Doriana Di Costa, Giuseppe Rovere, Maria Rosaria Matrangolo, Fernando De Maio, Pasquale Farsetti, Antonio Ziranu, Giulio Maccauro and Raffaele Vitiello

Curr. Oncol. 2023, 30(4), 3571-3579; https://doi.org/10.3390/curroncol30040272 - 24 Mar 2023

Cited by 4 | Viewed by 2104

Abstract

(1) Background: Some of the goals of orthopedic surgical oncology are saving limbs and function. The humerus is the third most frequent site in primary tumors and one of the most involved sites for metastases. Prosthetic replacement with modular megaprosthesis is one of the treatment choices, but there are several types of complications, such as problems with function and pain. The aim of our study is to assess functional outcomes and shoulder instability in the reconstruction of proximal humerus metastases. (2) Methods: This is a retrospective observational study. Twenty-eight patients, with proximal humerus metastases, admitted to the department of Orthopaedics and Traumatology of our University Hospital between 2014 and 2022 were recruited. Each patient underwent resection and prosthetic replacement surgery with modular megaprosthesis. Clinical evaluation was assessed through MSTS score, WOSI index, and DASH score. (3) Results: Twenty patients were included in the study. Fairly good results, especially regarding pain, function, and emotional acceptance, were obtained in all three tests: DASH, MSTS, and WOSI. Patients who reported shoulder instability actually have worse outcomes than those who report having stable shoulders. In addition, patients with a resection >10 cm have worse outcomes than those who had a resection of 10 cm. No significant differences were found between the deltopectoral approach group and the lateral approach group. (4) Conclusions: Reconstructive surgery with megaprosthesis of the proximal humerus in patients with metastases can be considered a treatment option, especially in patients with pathological fractures or injuries with a high risk of fracture and good life expectancy. This study shows how this type of surgery affects instability, but in terms of functionality, pain, and patient satisfaction, it gives satisfactory results. Full article

(This article belongs to the Special Issue What’s New in Musculoskeletal Oncology?)

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11 pages, 1583 KiB

Open AccessArticle

Pedicled Functional Latissimus Flaps for Reconstruction of the Upper Extremity following Resection of Soft-Tissue Sarcomas

by Alexandra M. Arguello, Mikaela H. Sullivan, Gavin L. Mills, Steven L. Moran and Matthew T. Houdek

Curr. Oncol. 2023, 30(3), 3138-3148; https://doi.org/10.3390/curroncol30030237 - 7 Mar 2023

Cited by 2 | Viewed by 3612

Abstract

(1) Background: Resection of soft-tissue sarcomas (STS) of the upper extremity can result in substantial functional impairment with limited options for functional reconstruction. Free functional latissimus flaps have been utilized to restore function of the thigh; however, there is limited data on the use of latissimus flaps for functional reconstruction in the upper extremity. As such, we sought to evaluate our institutional experience with these flaps. (2) Methods: We reviewed ten (seven male; three female; and a mean age of 63 years) patients undergoing soft-tissue sarcoma resection involving the triceps (n = 4), biceps (n = 4), and deltoid (n = 2) reconstructed with a pedicled functional latissimus flap. All surviving patients had at least 1 year of follow-up, with a mean follow-up of 5 years. (3) Results: The mean elbow range of motion and shoulder elevation were 105° and 150°. The mean Musculoskeletal Tumor Society score was 88%, and the muscle strength was four. Four patients had a recipient site wound complication. There were no flap losses. One patient sustained a radiation-associated humerus fracture 5 years postoperatively, treated nonoperatively. (4) Conclusions: Although early complications are high, pedicled functional latissimus flaps allow for wound coverage, potential space obliteration, and restoration of function in the upper extremity following resection of large soft tissue sarcomas. Full article

(This article belongs to the Special Issue What’s New in Musculoskeletal Oncology?)

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10 pages, 1467 KiB

Open AccessArticle

Percutaneous CT-Guided Microwave Ablation Combined with Pedicle Screw Fixation Followed by Vertebroplasty (MASFVA): Initial Experience of a Minimally Invasive Treatment of Vertebral Metastases with Extension to the Vertebral Pedicle

by Claudio Pusceddu, Salvatore Marsico, Daniele Derudas, Nicola Ballicu, Luca Melis, Carlo de Felice, Alessandro Calabrese, Domiziana Santucci and Eliodoro Faiella

Curr. Oncol. 2023, 30(2), 1663-1672; https://doi.org/10.3390/curroncol30020127 - 30 Jan 2023

Cited by 3 | Viewed by 2120

Abstract

(1) Background: The aim of this study was to retrospectively evaluate the safety and efficacy of a combined CT-guided percutaneous microwave ablation (MWA) and pedicle screw fixation followed by vertebroplasty (MASFVA) for the treatment and stabilization of painful vertebral metastases with vertebral pedicle involvement. (2) Methods: from January 2013 to January 2017 11 patients with 16 vertebral metastatic lesions (7 men and 5 women; mean age, 65 ± 11 years) with vertebral metastases underwent CT-guided microwave ablation and screw fixation followed by vertebroplasty (MASFVA). Technical success, complication rate, pain evaluation using a visual analogue scale (VAS), Oswestry Disability Index (ODI) and local tumor control were examined. (3) Results: Technical success rate was 100%. No procedure-related major complications occurred. VAS score decreased from 6.8 ± 0.7 to 0.6 ± 0.6. ODI score decreased from 3.1 ± 0.7 to 1.2 ± 0.4. All patients could walk independently without neurological complication after one week from the procedure. No new bone fractures or local disease recurrence occurred during a median follow-up of 12 months. (4) Conclusions: Our results suggest that MWA and percutaneous pedicle screw fixation followed by vertebroplasty for the treatment of painful vertebral metastases is a safe and effective procedure for painful vertebral metastases with vertebral pedicle involvement, allowing pain relief and local tumor control. Full article

(This article belongs to the Special Issue What’s New in Musculoskeletal Oncology?)

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17 pages, 1497 KiB

Open AccessArticle

Outcome of Reoperation for Local Recurrence Following En Bloc Resection for Bone Giant Cell Tumor of the Extremity

by Shinji Tsukamoto, Andreas F. Mavrogenis, Suraj Hindiskere, Kanya Honoki, Akira Kido, Hiromasa Fujii, Tomoya Masunaga, Yasuhito Tanaka, Pramod S. Chinder, Davide Maria Donati and Costantino Errani

Curr. Oncol. 2022, 29(9), 6383-6399; https://doi.org/10.3390/curroncol29090503 - 5 Sep 2022

Cited by 6 | Viewed by 2338

Abstract

En bloc resection is typically performed to treat giant cell tumors of bone (GCTB), particularly when curettage can be challenging owing to extensive bone cortex destruction with soft tissue extension. Few reports have addressed the clinical outcomes after reoperation for local recurrence in patients with GCTB who underwent en bloc resection. In this multicenter retrospective study, we investigated local recurrence, distant metastasis, malignant transformation, mortality, and limb function in patients treated for local recurrence following en bloc resection for GCTB. Among 205 patients who underwent en bloc resection for GCTB of the extremities between 1980 and 2021, we included 29 with local recurrence. En bloc resection was performed for large tumors with soft tissue extension, pathological fractures with joint invasion, complex fractures, and dispensable bones, such as the proximal fibula and distal ulna. Local re-recurrence, distant metastasis, malignant transformation, and mortality rates were 41.4% (12/29), 34.5% (10/29), 6.9% (2/29), and 6.9% (2/29), respectively. The median Musculoskeletal Tumor Society score was 26 (interquartile range, 23–28). The median follow-up period after surgery for local recurrence was 70.1 months (interquartile range, 40.5–123.8 months). Local recurrence following en bloc resection for GCTB could indicate an aggressive GCTB, necessitating careful follow-up. Full article

(This article belongs to the Special Issue What’s New in Musculoskeletal Oncology?)

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13 pages, 1033 KiB

Open AccessSystematic Review

Reconstruction after Talar Tumor Resection: A Systematic Review

by Shinji Tsukamoto, Andreas F. Mavrogenis, Kanya Honoki, Akira Kido, Yuu Tanaka, Hiromasa Fujii, Yoshinori Takakura, Yasuhito Tanaka and Costantino Errani

Curr. Oncol. 2022, 29(12), 9788-9800; https://doi.org/10.3390/curroncol29120769 - 12 Dec 2022

Cited by 2 | Viewed by 2170

Abstract

This systematic review investigated the functional outcomes and complications of reconstruction methods after talar tumor resection. A systematic search of PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases identified 156 studies, of which 20 (23 patients) were ultimately included. The mean Musculoskeletal Tumor Society scores in the groups reconstructed using tibiocalcaneal fusion (n = 17), frozen autograft (n = 1), and talar prosthesis (n = 5) were 77.6 (range 66–90), 70, and 90 (range 87–93), respectively. Regarding complications, sensory deficits were observed in one patient (6%) and venous thrombosis in two patients (12%) in the tibiocalcaneal fusion group, while osteoarthritis was observed in one patient (100%) in the frozen autograft group. No complications were observed in the talar prosthesis group. Reconstruction with talar prosthesis seems preferable to conventional tibiocalcaneal fusion after talar tumor resection because it offers better function and fewer complications. However, as this systematic review included only retrospective studies with a small number of patients, its results require re-evaluation in future randomized controlled trials with larger numbers of patients. Full article

(This article belongs to the Special Issue What’s New in Musculoskeletal Oncology?)

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