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

Yoshihiro Araki,Hiroyuki Tsuchiya,Takashi Higuchi,Shinji Miwa,Yuta Taniguchi,Yohei Asano,Kentaro Igarashi,Akihiko Takeuchi,Katsuhiro Hayashi,Hirotaka Yonezawa,Kensaku Abe,Sei Morinaga,Norio Yamamoto

doi:10.1038/s41598-021-96162-5

Yoshihiro Araki, Hiroyuki Tsuchiya + Show 11 more

Open Access

https://doi.org/10.1038/s41598-021-96162-5

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Journal: Scientific Reports	Publication Date: Aug 27, 2021
Citations: 11	License type: open-access

Affiliation: Kanazawa University

Abstract

Age 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.

Highlights

Age affects the clinical outcomes of cancer treatment, including those for bone sarcoma
The patient charatcteristics were investigated separately and compared in the three different age groups, and there were no significant differences in patients characteristics regarding sex, follow-up period, tumor location, staging, freezing procedure, or reconstruction method in the three age groups (Table 1)
Osteosarcoma showed a lower rate in older adults than in children and AYA patients, but, the histology in all cases in the present study was primary bone sarcoma

Summary

Introduction

Age affects the clinical outcomes of cancer treatment, including those for bone sarcoma. 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. Frozen autograft reconstruction for AYAs showed excellent clinical outcomes, the long-term follow-up is required. Abbreviations AYA Adolescents and young adults AJCC American Joint Committee on Cancer OS Overall survival RFS Recurrence-free survival GS Graft survival MSTS Musculoskeletal Tumor Society MRI Magnetic reasonance imaging CT Computed tomography. Reconstruction using a tumor prosthesis is commonly performed after excision of bone tumors in all generations[9,10] This type of reconstruction has a limited durability and several reoperations will be necessary, especially for young patients. The reasons for revision surgery include mechanical failure, loosening, chronic infection, and other c onditions[9,10,11,12]

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Results

Conclusion