scholarly journals Isolated chemoperfusion of the lung and pleura as a method of treatment in children with common forms of solid bone tumors

2019 ◽  
Vol 6 (1) ◽  
pp. 40-47
Author(s):  
E. V. Levchenko ◽  
E. D. Gumbatova ◽  
S. A. Kuleva ◽  
K. Yu. Senchik ◽  
O. Yu. Mamontov ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bone Tumors ◽  
Pleural Cavity ◽  
Malignant Tumors ◽  
Treatment Options ◽  
Systemic Exposure ◽  
Parietal Pleura ◽  
Malignant Bone Tumors ◽  
Surgical Interventions ◽  
Isolated Lung

Introduction. Therapy of malignant tumors is one of the most important problems of modern pediatric oncology. The presence of distant metastases is considered as the main sign of generalization of the tumor process. In order to improve the results of treatment of these patients, we proposed to supplement cytoreductive surgery with intraoperative isolated chemoperfusion of the lung and/or pleura with cytostatic. The purpose of the study is to determine the effectiveness of metastasectomy combined with isolated lung/pleura chemoperfusion (ILCP/PCP) under conditions of hyperoxia in children. Materials and methods. For 10 years of research (2008–2018) on the basis of the N.N. Petrov National Medical Research Center of Oncology produced 45 ILCP and PCP in 30 patients with intrapulmonary and intrapleural metastases of various malignant bone tumors. The ILCP method is a surgical procedure, during which the lung is temporarily switched off from the circulation and perfused with modified saline containing high concentrations of an antitumor drug (melphalan or cisplatin), which allows delivery of high doses of cytostatics while avoiding systemic exposure to the drug. In cases of detection of metastatic lesions of the parietal pleura after metastasectomy, PCP was performed, consisting in drainage of the pleural cavity and intraoperatively conducting, after suturing the surgical wound, hyperthermic (42 o С) chemoperfusion of the pleural cavity with a cisplatin solution for 2 hours. Results. In children with malignant bone tumors, 37 isolated chemoperfusions with cisplatin and 8 with melphalan were performed. In 27 patients, 36 ILCP were performed, in 7 patients – 9 PCP. Nine (20 %) patients underwent bilateral perfusion with an interval from 1.5 to 31 months. There were no lethal outcomes during operations and in the postoperative period. The average duration of surgical interventions was 270 ± 90 (120–520) minutes. The number of remote foci – from 1 to 56 (average value – 9). The average blood loss was 300 ± 200 (150–1000) ml. The mean follow-up was 45 months; median overall survival – 38 months; 3-year overall survival – 65.5 ± 9.4 %. Survival without progression – 40.5 ± 10.5 % (n = 30). Conclusions. ILCP/PCP with cytostatics is a method of complex therapy that can improve the quality and increase the life expectancy of patients, especially with the exhausted possibility of other treatment options.

scholarly journals Extragenital endometriosis as a cause of catamenial pneumothorax in women: own experience

2021 ◽  
pp. 27-31
Author(s):  
Valery Boyko ◽  
Andriy Krasnoyaruzhsky ◽  
Anastasiia Sochnieva ◽  
Vasyl Kritsak
Keyword(s):  
Pleural Cavity ◽  
Treatment Algorithm ◽  
Parietal Pleura ◽  
Medical Sciences ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Catamenial Pneumothorax ◽  
Second Stage ◽  
Minimally Invasive Surgical ◽  
Extragenital Endometriosis

Introduction. Catamenial pneumothorax is one of the most difficult to diagnose types of spontaneous pneumothorax in women. The cause of the latter is ectragenital localization of endometriosis. To date, there is no clear pathogenetically determined treatment and treatment algorithm for the management of this category of patients. Objective: to analyze and structure our own experience in the treatment of catamenial pneumothorax. Materials and methods. For the period 2011–2020 in the Thoracoabdominal Department of the SI "Zaytcev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine" 7 women with catamenial pneumothorax were on inpatient treatment. Results. After additional examination, all patients underwent draining of the pleural cavity with Bulau as the first stage after the diagnosis was established. At the second stage, all patients underwent minimally invasive surgical interventions – videothoracoscopic resection of the endometriosis-affected areas of the costal parietal pleura and diaphragm, mechanical pleurarasion and pleurodesis, using fibrin-collagen plates in the areas of diaphragm defects. There were no postoperative complications or deaths. Conclusion. In the treatment of extragenital endometriosis complicated by catamenial pneumothorax, not only thoracic surgeons, but also obstetrician-gynecologists should take part in order to create multidisciplinary commissions aimed primarily at determining the pathogenetically determined treatment tactics. Key words: extragenital endometriosis, catamenial pneumothorax, videothoracoscopy, surgical treatment.

scholarly journals Diffusion-weighted Magnetic Resonance Imaging in the Diagnosis of Bone Tumors: Preliminary Results

2013 ◽  
Vol 3 ◽  
pp. 63 ◽  
Author(s):  
Yeliz Pekcevik ◽  
Mehmet Onur Kahya ◽  
Ahmet Kaya
Keyword(s):  
Magnetic Resonance ◽  
Bone Tumors ◽  
Malignant Tumors ◽  
Receiver Operating Curve ◽  
Benign Tumors ◽  
Single Shot ◽  
Malignant Bone Tumors ◽  
Diffusion Weighted ◽  
Adc Values ◽  
The Mean

Objective: The study aims to determine whether apparent diffusion coefficient (ADC) can help differentiate benign and malignant bone tumors. Materials and Methods: From January 2012 to February 2013, we prospectively included 26 patients. Of these 15 patients were male and 11 were female; ranging in age from 8 to 76 years (mean age, 34.5 years). Diffusion-weighted magnetic resonance (MR) imaging was obtained with a single-shot echo-planar imaging sequence using a 1.5T MR scanner. We grouped malignant lesions as primary, secondary, and primary tumor with chondroid matrix. The minimum ADC was measured in the tumors and mean minimum ADC values were selected for statistical analysis. ADC values were compared between malignant and benign tumors using the Mann-Whitney U-test and receiver operating curve analysis were done to determine optimal cut-off values. Results: The mean ADC values from the area with lowest ADC values of benign and malignant tumors were 1.99 ± 0.57 × 10−3 mm2/s and 1.02 ± 1.0 × 10−3 mm2/s, respectively. The mean minimum ADC values of benign and malignant tumors were statistically different (P = 0.029). With cut-off value of 1.37 (10−3 mm2/s), sensitivity was 77.8% and specificity was 82.4%, for distinguishing benign and malignant lesion. Benign and secondary malignant tumors showed statistically significant difference (P = 0.002). There was some overlap in ADC values between benign and malignant tumors. The mean minimum ADC values of benign and malignant chondroid tumors were high. Giant cell tumor, non-ossifying fibroma and fibrous dysplasia showed lower ADC values. Conclusion: Although there is some overlap, ADC values of benign and malignant bone tumors seem to be different. Further studies with larger patient groups are needed to find an optimal cut-off ADC value.

scholarly journals Relationship of the content of vitamin D and melatonin in blood serum and pineal gland calcifications in patients with malignant bone tumors

2021 ◽  
Vol 9 (1) ◽  
pp. 63-69
Author(s):  
Oleg Drobotun ◽  
Mykola Kolotilov ◽  
Mykola Safonov
Keyword(s):  
Vitamin D ◽  
Pineal Gland ◽  
Blood Serum ◽  
Vitamin D Deficiency ◽  
Bone Tumors ◽  
Malignant Tumors ◽  
Lower Extremities ◽  
Malignant Bone Tumors ◽  
Relationship Of ◽  
The Relationship

The aim of the study was to investigate the relationship between the vitamin D content, melatonin and the characteristics of pineal gland calcifications in patients with malignant tumors of the bones of the lower extremities. Vitamin D deficiency and pineal gland calcifications are observed in almost 100 % of patients with malignant tumors of the lower extremities’ bones. The high heterogeneity of calcifications and its dynamics during the treatment of patients may indicate the processes of their litholysis and dissolution.

Nomograms to predict lung metastasis probability and lung metastasis subgroup survival in malignant bone tumors

2021 ◽  
Vol 17 (6) ◽  
pp. 649-661
Author(s):  
Jie Wang ◽  
Yonggang Fan ◽  
Lei Xia
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Prognostic Factors ◽  
High Risk ◽  
Lung Metastasis ◽  
Bone Tumors ◽  
Malignant Bone Tumors ◽  
Tumor Extension ◽  
N Stage ◽  
Selection Operator

The aim of this study was to construct and validate nomograms for predicting lung metastasis and lung metastasis subgroup overall survival in malignant primary osseous neoplasms. Least absolute shrinkage and selection operator, logistic and Cox analyses were used to identify risk factors for lung metastasis in malignant primary osseous neoplasms and prognostic factors for overall survival in the lung metastasis subgroup. Further, nomograms were established and validated. A total of 3184 patients were collected. Variables including age, histology type, American Joint Committee on Cancer T and N stage, other site metastasis, tumor extension and surgery were extracted for the nomograms. The authors found that nomograms could provide an effective approach for clinicians to identify patients with a high risk of lung metastasis in malignant primary osseous neoplasms and perform a personalized overall survival evaluation for the lung metastasis subgroup.

scholarly journals A Web-Based Prediction Model for Overall Survival of Elderly Patients With Malignant Bone Tumors: A Population-Based Study

2022 ◽  
Vol 9 ◽  
Author(s):  
Jie Tang ◽  
JinKui Wang ◽  
Xiudan Pan
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Elderly Patients ◽  
Prediction Model ◽  
Bone Tumors ◽  
Receiver Operating Curve ◽  
Training Set ◽  
Malignant Bone Tumors ◽  
Independent Risk Factors ◽  
Validation Set

Background: Malignant bone tumors (MBT) are one of the causes of death in elderly patients. The purpose of our study is to establish a nomogram to predict the overall survival (OS) of elderly patients with MBT.Methods: The clinicopathological data of all elderly patients with MBT from 2004 to 2018 were downloaded from the SEER database. They were randomly assigned to the training set (70%) and validation set (30%). Univariate and multivariate Cox regression analysis was used to identify independent risk factors for elderly patients with MBT. A nomogram was built based on these risk factors to predict the 1-, 3-, and 5-year OS of elderly patients with MBT. Then, used the consistency index (C-index), calibration curve, and the area under the receiver operating curve (AUC) to evaluate the accuracy and discrimination of the prediction model was. Decision curve analysis (DCA) was used to assess the clinical potential application value of the nomogram. Based on the scores on the nomogram, patients were divided into high- and low-risk groups. The Kaplan-Meier (K-M) curve was used to test the difference in survival between the two patients.Results: A total of 1,641 patients were included, and they were randomly assigned to the training set (N = 1,156) and the validation set (N = 485). The univariate and multivariate analysis of the training set suggested that age, sex, race, primary site, histologic type, grade, stage, M stage, surgery, and tumor size were independent risk factors for elderly patients with MBT. The C-index of the training set and the validation set were 0.779 [0.759–0.799] and 0.801 [0.772–0.830], respectively. The AUC of the training and validation sets also showed similar results. The calibration curves of the training and validation sets indicated that the observed and predicted values were highly consistent. DCA suggested that the nomogram had potential clinical value compared with traditional TNM staging.Conclusion: We had established a new nomogram to predict the 1-, 3-, 5-year OS of elderly patients with MBT. This predictive model can help doctors and patients develop treatment plans and follow-up strategies.

A Web-based Prediction Model for Overall Survival of Elderly Patients With Malignant Bone Tumors: a Population-based Study

2021 ◽  
Author(s):  
Jie Tang ◽  
Jinkui Wang ◽  
Xiudan Pan
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Elderly Patients ◽  
Prediction Model ◽  
Bone Tumors ◽  
Receiver Operating Curve ◽  
Training Set ◽  
Malignant Bone Tumors ◽  
Independent Risk Factors ◽  
Validation Set

Abstract Background: Malignant bone tumors(MBT) are one of the causes of death in elderly patients. The purpose of our study is to establish a nomogram to predict the overall survival(OS) of elderly patients with MBT.Methods: The clinicopathological data of all elderly patients with MBT from 2004 to 2018 were downloaded from the SEER database. They were randomly assigned to the training set (70%) and validation set (30%). Univariate and multivariate Cox regression analysis was used to identify independent risk factors for elderly patients with MBT. A nomagram was built based on these risk factors to predict the 1-, 3-, and 5-year OS of elderly patients with MBT. Then, used the consistency index (C-index), calibration curve, and the area under the receiver operating curve(AUC) to evaluate the accuracy and discrimination of the prediction model. Decision curve analysis(DCA) was used to evaluate the clinical potential application value of nomogram. Based on the scores on the nomogram, patients were divided into high- and low-risk groups. Kaplan-Meier (K-M) curve was used to test the difference in survival between the two groups of patients.Results: A total of 1641 patients were included, and they were randomly assigned to the training set (N=1156) and the validation set (N=485). The univariate and multivariate analysis of the training set suggested that age, sex, race, primary site, histologic type, grade, stage, M stage, surgery, and tumor size were independent risk factors for elderly patients with MBT. The C-index of the training set and the validation set were 0.779[0.759-0.799] and 0.801[0.772-0.830], respectively. The AUC of the training set and the validation set also showed similar results. The calibration curves of the training set and the validation set both showed that the observed value and the predicted value were highly consistent. DCA suggested that the nomogram had potential clinical value compared with traditional TNM staging.Conclusion: We had established a new nomogram to predict the 1-, 3-, 5-year OS of elderly patients with MBT. This predictive model can help doctors and patients develop treatment plans and follow-up strategies.

Malignant Bone Tumors of the Knee: How to Identify and Treat

2018 ◽  
Vol 32 (04) ◽  
pp. 305-314
Author(s):  
Ryan Voskuil ◽  
Andrea Evenski ◽  
Corey Montgomery ◽  
Cynthia Emory
Keyword(s):  
Bone Tumors ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Chemotherapy Response ◽  
Malignant Bone Tumors ◽  
Cancer Society ◽  
Delay In Diagnosis ◽  
Increased Risk ◽  
Prior Literature ◽  
Life Threatening

AbstractMalignant bone tumors are rare conditions that may be encountered by nononcologic surgeons only a few times in their careers, but a delay in diagnosis or a misinterpretation of data can have limb and life-threatening consequences. Prior literature suggests that unplanned resection of sarcoma was associated with an increased risk of local recurrence, decreased 10-year survival, and increased amputation rate compared with planned resection. In addition to patient morbidity, missed diagnoses and unplanned excisions of malignant tumors lead to increased cost of treatment and higher likelihood of subsequent medicolegal action. According to the American Cancer Society, the 5-year survival of all combined cases of malignant bone tumors is approximately 70%. However, the survival rate of each type of malignant bone tumor varies, with multiple myeloma survival rates being much lower and lymphoma somewhat higher. These rates depend on many factors including grade, stage, and chemotherapy response. For example, the 10-year survival of localized osteosarcoma is almost 70%, yet rapidly declines to 20 to 30% in patients with metastases. This further emphasizes the elevated importance of prompt recognition and treatment of malignant bone tumors.

Sign in / Sign up

Export Citation Format

Share Document