Validation of the Brazilian Version of the Musculoskeletal Tumor Society Rating Scale for Lower Extremity Bone Sarcoma

Abstract Background: Surgical resection and reconstruction for low grade bone sarcoma in the metaphysis of the long bone remains challenging. We hypothesize that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function without higher recurrence rate. Methods: From January 2017 to August 2019, ten patients with low-grade malignant bone tumor in metaphysis of the limbs were treated with hemicortical resection using 3D printing guide plate and biological reconstruction. Results: Four patients were paracorticular osteosarcoma, five cases had highly differentiated chondrosarcoma, and one case was a chondromyxoid fibroma. Two of the cases involved the proximal humerus, while eight cases involved the distal femur. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society score averaged at 27.1, while the International Society of Limb Salvage imaging score examination averaged 87.8%. Conclusions: Here, we demonstrate that the 3D printing osteotomy guide plate assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of long bone and restore excellent joint function.

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Plastic lengthening amputation with vascularized bone grafts in children with bone sarcoma: a preliminary report

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02020-5 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Zhiqiang Zhao ◽

Qinglin Jin ◽

Xianbiao Xie ◽

Yongqian Wang ◽

Tiao Lin ◽

...

Keyword(s):

Functional Outcomes ◽

Young Patients ◽

Bone Sarcoma ◽

Postoperative Management ◽

Functional Score ◽

Leg Length ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society ◽

Functional Scores ◽

Distal Joint

Abstract Background At present, amputation was widely adopted for young patients when limb salvage was deemed risky with several surgical strategy such as rotationplasty. However, leg length discrepancies and unfavorable cosmetic results were indispensable complication of this strategy. The purpose of this study was to propose a novel reconstruction strategy and evaluate the early clinical and functional outcomes of the strategy. Methods Plastic lengthening amputation (PLA) has been developed by lengthening the stump to preserve one additional distal joint for fixing the artificial limb well. The surgical technique and postoperative management were documented, and the functional outcomes were compared with those of traditional amputation (TA). Six pairs of patients matched for age, sex, location, pathological type, and final prosthesis underwent individually designed plastic lengthening amputation with vascularized autografts or traditional amputation between January 2005 and December 2007. All patients were followed, and the locomotor index and the musculoskeletal tumor society score (MSTS) were used to describe and quantitatively grade limb functional outcomes after amputation. The complications and functional outcomes of the patients taken two kinds of procedures were compared. Results Twelve patients with osteosarcoma or Ewing’s sarcoma of either the femur or tibia were included in the study. Six patients underwent plastic lengthening amputations, three of whom also underwent vascular anastomosis. Patients were followed for an average of 48.17 months; bone healing required an average of 3.3 months. No local recurrence was found. The average postoperative locomotor index functional score of the affected limb was 32.67 ± 5.89 in the plastic lengthening amputation group while was 19.50 ± 7.87 in the traditional amputation group. The MSTS functional scores were 22.67 ± 1.33 and 24.17 ± 1.45 at 6 and 12 months for patients in PLA group while 17.00 ± 1.549 and 17.83 ± 1.64 at 6 and 12 months for patients in TA group. Conclusions Plastic lengthening amputations with vascularized autografts could preserve the knee joint to improve the function of the amputated limb in selected bone sarcoma patients.

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Complex Biological Reconstruction after Wide Excision of Osteogenic Sarcoma in Lower Extremities

Plastic Surgery International ◽

10.1155/2013/538364 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Kashif Abbas ◽

Masood Umer ◽

Haroon ur Rashid

Keyword(s):

Lower Extremity ◽

Surgical Approach ◽

Osteogenic Sarcoma ◽

Limb Salvage Surgery ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society ◽

Gastrocnemius Flap ◽

Fillet Flap ◽

Vascularized Fibula ◽

Functional Limb

Wide margin resection of extremity tumor sometimes leaves a huge soft tissue and bony defects in limb salvage surgery. Adequate management of these defects is an absolute requirement when aiming for functional limb. Multidisciplinary management in such cases is an answer when complex biologic reconstruction is desired. We aim to present cases of osteogenic sarcoma of lower extremity requiring combined surgical approach to achieve effective musculoskeletal reconstruction. Patients and Methods. From 2006 to 2010 ten patients were operated on for osteogenic sarcoma of lower extremity requiring complex musculoskeletal reconstruction. Results. Six patients had pathology around knee joint, whereas one each with mid tibia, mid femur, proximal femur, and heel bone. Locking compression plate was used in 7 patients including six with periarticular disease. Eight out of ten patients underwent biologic reconstruction using autograft; endoprosthetic reconstruction and hindquarter amputation were done in the remaining two patients. Vascularized fibula was done in five patients, sural artery flap which was primarily done in three patients, spare part fillet flap, free iliac crest flap, and Gastrocnemius flap was done in one patient each. Secondary hemorrhage, infection, nonunion, wound dehiscence, and flap failure were notable complications in four patients. The Average Musculoskeletal Tumor Society score was 89%. Conclusion. Combined surgical approach results in cosmetically acceptable and functional limb.

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Functional Outcome After Lower Extremity Soft Tissue Sarcoma Treatment: A Pilot Study Based on Translated and Culturally Adapted Measures

Scandinavian Journal of Surgery ◽

10.1177/1457496918798210 ◽

2018 ◽

Vol 108 (2) ◽

pp. 164-171

Author(s):

G. Kask ◽

I. Barner-Rasmussen ◽

J. Repo ◽

C. Blomqvist ◽

E. Tukiainen

Keyword(s):

Pilot Study ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Lower Extremity ◽

Functional Outcome ◽

Soft Tissue Sarcomas ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society ◽

Toronto Extremity Salvage Score ◽

Extremity Salvage

Background and Aims: The present standard of care in treating lower extremity soft tissue sarcomas is function-sparing, limb-preserving resection and reconstruction with or without oncological therapy. The aim of this pilot study was to test the suitability and adequacy of the Finnish translations of two functional outcome questionnaires (Toronto Extremity Salvage Score and Musculoskeletal Tumor Society score) and to perform a preliminary investigation of functional outcomes of Finnish lower-limb soft tissue sarcoma patients after operative treatment. Materials and Methods: Between June 2015 and December 2015, consecutive surgically treated outpatients were asked to participate in the study. Demographic, clinical, surgical, and oncological outcome data were collected. Two functional outcome questionnaires were used (Toronto Extremity Salvage Score and Musculoskeletal Tumor Society scores). A comparative analysis is presented. Results: A total of 19 lower-limb soft tissue sarcoma patients with a mean follow-up time of 2 years and 10 months were included. All (n = 19) invited patients participated in the study. Mean age was 62.3 years. In total, 13 had high-grade sarcomas. Eight wounds were closed directly, four used skin grafts, and five required flap reconstructions. One patient required a tumor prosthesis, and one required a rotationplasty. A total of 14 patients received oncological therapy. No problems or difficulties were reported in using and completing the Finnish versions of the Toronto Extremity Salvage Score or Musculoskeletal Tumor Society questionnaires. The overall Toronto Extremity Salvage Score and Musculoskeletal Tumor Society scores were 88 and 76, respectively. Conclusion: This pilot study suggests that the Finnish versions of the Toronto Extremity Salvage Score and Musculoskeletal Tumor Society questionnaires are suitable for measuring functional outcome after lower extremity soft tissue sarcomas treatment. Functional outcomes vary from moderate to excellent.

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Clinical outcomes of frozen autograft reconstruction for the treatment of primary bone sarcoma in adolescents and young adults

Scientific Reports ◽

10.1038/s41598-021-96162-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yoshihiro Araki ◽

Norio Yamamoto ◽

Katsuhiro Hayashi ◽

Akihiko Takeuchi ◽

Shinji Miwa ◽

...

Keyword(s):

Young Adults ◽

Clinical Outcomes ◽

Bone Sarcoma ◽

Adolescents And Young Adults ◽

Appendicular Skeleton ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society ◽

Primary Bone Sarcoma ◽

Primary Bone

AbstractAge affects the clinical outcomes of cancer treatment, including those for bone sarcoma. Successful reconstruction using frozen autograft after excision of bone sarcoma has been reported; however, little is known about the clinical outcomes of frozen autograft reconstruction according to age. The purpose was to evaluate the clinical outcomes of the frozen autograft reconstruction focusing on skeletally mature adolescents and young adults (AYAs) that was 15 to 39 years of age. A total of 37 AYA patients with primary bone sarcoma on the appendicular skeleton were enrolled in this study. The mean follow-up period was 89 months. The graft survival (GS), overall survival (OS), recurrence-free survival (RFS), complications and the function were retrospectively evaluated using medical records. The 10-year GS, OS, and RFS rates were 76%, 84%, and 79%, respectively. Bone union was achieved with a rate of 94% within 1 year after surgery, and nonunion (n = 1) and fracture (n = 2) were infrequently observed. Graft removal was performed in 7 cases, and the most common reason for the removal was infection (n = 5). The Musculoskeletal Tumor Society score was excellent in 23 cases of the available 29 cases. Frozen autograft reconstruction for AYAs showed excellent clinical outcomes, although the long-term follow-up is required.

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Tradução e validação do instrumento Musculoskeletal Tumor Society Rating Scale (MSTS) para avaliação da função em pacientes com sarcomas ósseos dos membros inferiores

10.11606/d.5.2012.tde-05042012-095050 ◽

2012 ◽

Author(s):

Daniel César Seguel Rebolledo

Keyword(s):

Rating Scale ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society

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Surveillance Strategies for Sarcoma: Results of a Survey of Members of the Musculoskeletal Tumor Society

Sarcoma ◽

10.1155/2016/8289509 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

David D. Greenberg ◽

Brooke Crawford

Keyword(s):

Soft Tissue ◽

Radiation Exposure ◽

Tumor Size ◽

Surgical Margin ◽

Bone Sarcoma ◽

Histologic Grade ◽

Public Health Issue ◽

Evidence Based ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society

Background. Surveillance is crucial to oncology, yet there is scant evidence to guide strategies.Purpose. This survey identified sarcoma surveillance strategies for Musculoskeletal Tumor Society (MSTS) members and rationales behind them. Understanding current practice should facilitate studies to generate evidence-based surveillance protocols.Methods. Permission was granted by the Research and Executive Committee of the MSTS to survey members on surveillance strategies. First, the questionnaire requested demographic and clinical practice information. Second, the survey focused on clinicians’ specific surveillance soft tissue and bone sarcoma protocols.Results. 20 percent of MSTS members completed the survey. The primary rationale for protocols was training continuation, followed by published guidelines, and finally personal interpretation of the literature. 95% of the respondents believe that additional studies regarding appropriate surveillance protocols are needed. 87% reported patient concerns regarding radiation exposure from surveillance imaging. For soft tissue and bone sarcoma local recurrence, responders identified surgical margin, histologic grade, and tumor size as the most important factors. For metastases, important risk factors identified included histologic grade, tumor size, and histologic type. Protocols demonstrated wide variation.Conclusion. This survey demonstrates that surveillance strategies utilized by MSTS members are not evidence-based, providing rationale for multi-institutional studies. It also confirms the public health issue of excessive radiation exposure.

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The long-term results of extendable endoprostheses of the humerus in children after the resection of a bone sarcoma

The Bone & Joint Journal ◽

10.1302/0301-620x.102b12.bjj-2020-0124.r1 ◽

2020 ◽

Vol 102-B (1) ◽

pp. 64-71

Author(s):

Yusuke Tsuda ◽

Tomohiro Fujiwara ◽

Jonathan D. Stevenson ◽

Michael C. Parry ◽

Roger Tillman ◽

...

Keyword(s):

Bone Sarcoma ◽

Long Term Results ◽

Functional Score ◽

Endoprosthetic Replacement ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society ◽

Initial Surgery ◽

The Mean

Aims The purpose of this study was to report the long-term results of extendable endoprostheses of the humerus in children after the resection of a bone sarcoma. Methods A total of 35 consecutive patients treated with extendable endoprosthetic replacement of the humerus in children were included. There were 17 boys and 18 girls in the series with a median age at the time of initial surgery of nine years (interquartile range (IQR) 7 to 11). Results The median follow-up time was 10.6 years (IQR 3.9 to 20.4). The overall implant survival at ten years was 75%. Complications occurred in 13 patients (37%). Subluxation at the proximal humerus occurred in 19 patients (54%) but only six (17%) were symptomatic. Subluxation was seen more commonly in children under the age of nine years (86%) than in those aged nine years or more (33%) (p = 0.002). Implant failure occurred in nine patients (26%): the most common cause was aseptic loosening (four patients, 11%). Lengthening of the implant was carried out in 23 patients (66%). At final follow up, three patients had a limb that was shortened by 5 cm or more. The mean Musculoskeletal Tumor Society (MSTS) functional score was 79% (73% to 90%). Conclusion Extendable endoprosthetic replacement is a reliable method of reconstructing humerus after excision of a bone sarcoma. Children who are less than nine years old have a high risk of subluxation. Cite this article: Bone Joint J 2020;102-B(1):64–71

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