Bone Tumors Research Articles

The Impact of Social Determinants of Health on the Prognosis of Primary Bone Tumors: A Systematic Review.

Although the prevalence of primary bone tumors (PBTs) was reported to be relatively low, they represent a difficult category of tumors for appropriate prediction, prevention, diagnosis, and treatment. Among different factors contributing to the prognosis and treatment outcomes of patients with these tumors, it is assumed that social determinants of health (SDOH) have not been well investigated nor applied in the process of decision making for these patients. In this systematic review, databases including PubMed, Web of Science, Scopus, Embase, Science Direct, and CINAHL were used. To ensure the quality of the studies and assess them for bias, we used the Methodological Index for Nonrandomized Studies scaling tool. The relevant data were extracted from the included studies and reported. Twenty-five studies were included in our review based on the inclusion criteria. Age, socioeconomic status, education, and employment status; place of living and neighborhood; race and ethnicity; and insurance coverage were found to impact the outcomes and prognosis of PBTs. Literature has shown correlations of various SDOH with the outcomes of PBTs. SDOH are not independent of each other; including and interpreting them in the process of decision making should be in a multifactorial and intercalated manner. We suggest prospective studies on finding the effect of inventing with SDOH through changes in health care policies, educating patients and care providers, improving socioeconomic conditions, and providing better insurance support, on the outcomes of PBTs. Level III. See Instructions for Authors for a complete description of levels of evidence.

Calcium-based nanowires for bone repair

Abstract Bone defects due to the older population, severe trauma, congenital malformations, resection of bone tumors, and infections are serious problems faced in orthopedic clinical treatment, posing great hazards to human health and life, and external interventions are generally required to promote bone healing. Considering the osteogenic promotion of calcium ions, Ca-POM nanowires were synthesized in this study to facilitate the osteogenesis process through the release of calcium ions. The cytotoxicity test showed that the material possesses good biocompatibility. Furthermore, the Alizarin Red S staining demonstrated that the material could promote osteogenesis, indicating its potential as an ideal candidate for bone repair.

Foot Tumor: Comprehensive Collation and Evaluation

Background: Considerable evidence showed that foot tumors can cause severe harm to people across various age groups, though they have relatively low incidence rate. Currently, substantial research articles provide thorough discoveries among diagnosis, treatment, reconstruction, and other related areas. However, a comprehensive literature evaluation of current study findings is required. Methods: A search approach implementing the PICOS principle was utilized to acquire the literature from mainly three databases—PubMed, NCBI and SpringerLink. All the included studies underwent independent screening and evaluations of quality and risk of bias. The outcomes covered evaluation and comparison of various tumor kinds, diagnostic techniques, treatment modalities, and reconstructive procedures. Results: The location of the foot is characterized by the presence of three primary bone tumor types — osteosarcoma (OS), chondrosarcoma (CDS) and Ewing sarcoma (ES)— and four forms of soft tissue tumor—Synovial sarcoma (SS), epithelioid sarcoma (EPS), clear cell (CC) sarcoma and melanoma. Diagnosis involves the utilization of four approaches—CT, MRI, X-ray and biopsy, either singly or in combination. Out of all the options, biopsy is the most effective and accurate. Surgery and immunotherapy are widely used to treat foot tumor. The advancement of immunotherapy can significantly improve the efficiency and effectiveness of foot tumor treatment due to its specific targets and better established adjustment mechanism. Combining various types of immunotherapy with additional medicines such as chemotherapy and radiotherapy can help improve the progression of foot tumor treatment. For the reconstruction methods, Structural allograft Plastic surgery is widely used for bone tumor and soft tissue sarcoma respectively. Conclusion: The clinical significance of foot tumors is attributed to their infrequency, resulting high possibility of delayed detection and difficulties in proper treatment. The text that provides a comprehensive discussion and analysis of the diagnostic, therapeutic tactics, and repair approaches for the foot tumor can be highly beneficial to the development of foot tumor in the medical area. The methodical collation on characteristics, data of foot tumor categories is therefore equally significant. By obtaining and analyzing such information, researchers and physicians can better identify certain pattern in foot tumor. For the treatment, Immunotherapy stands out among the existing methods since it has the highest potential to selectively target certain types of foot tumors depending on their distinct needs. The evaluation of immunotherapy and reconstruction methods still contain some limitations due to the lack of the latest and adequate research.

Original Research: Proximal Tibia Hemiarthroplasty Reconstruction Following Resection of Malignant Bone Tumors in Skeletally Immature Patients

BackgroundReconstruction of the proximal tibia following resection of malignant bone tumors in pediatric patients is traditionally limited to osteoarticular allografts or endoprostheses. Endoprostheses typically require resection or disruption of the distal femoral physis, which can lead to a leg length discrepancy (LLD). We introduce a novel form of proximal tibia limb reconstruction using a Compress® tibia hemiarthroplasty, which spares the distal femoral physis. MethodsWe retrospectively reviewed 5 patients who underwent proximal tibia osteosarcoma resection and reconstruction with a custom Compress® proximal tibia hemiarthroplasty. Data on function, survival, LLD, complications, and patient reported outcomes were collected. ResultsMean age at resection was 10.4 years[range:8.8-12.9 years]. Mean implant survival was 59 months[range:34-83 months]. One patient developed a deep infection and two patients required implant lengthening. Both were later converted to a rotating hinged total knee arthroplasty(RHTKA) >58 months after index surgery. At last follow-up, all living patients had knee ROM from 0-110 degrees, walked unassisted, and had no LLD or knee instability. Mean TESS score was 90[range:80-97]. ConclusionProximal tibia hemiarthroplasty reconstruction after tumor resection in skeletally immature patients preserves the distal femoral physis, and may potentially reduce LLD and delay conversion to a RHTKA until after skeletal maturity. Level of EvidenceCase Series, level IV.

Combined use of PRPP, diode laser and piezosurgery device improves reparative osteogenesis previously to dental implants placement

ObjectiveCurrent study evaluated whether use of the platelet-rich powder (PRPP), piezosurgery device and diode laser after removal of jawbones cysts and benign bone formations and extraction of impacted tooth could enhance bone regeneration before dental implantation. MethodsA study was conducted among 200 patients with post-surgical cavities (not exceeding 1.5 cm upon cystectomy, benign bone tumor removal and impacted tooth extraction) who underwent plasma powder, autograft, allograft, xenograft or beta-tricalcium phosphate augmentation procedures. ResultsPRPP implantation in combination with irradiation of bone cavity by diode laser led to the formation of 15.40 % ± 2.1 of new bone. The activity of reparative osteogenesis on the bone surface was BB = 6.71 ± 1.3, which is 3 and 3.5 times higher than the mean value in comparison group after augmentation of xenograft and beta-tricalcium phosphate. The value of bone tissue resorption for main group patients was less pronounced (Ra.Oc = 25.20 % ± 2.1).The ratio between pro- and anti-inflammatory cytokines in the main group after 1, 7 and 30 days since surgical procedure was lower than the ratio of the corresponding cytokines in the comparison groups. ConclusionThe examination of computed tomograms, histological and morphometric analysis of bone tissue after trepanobiopsy, cytological analysis of swabs and enzyme immunoassay to determine local immunity indicated that the proposed method of treatment with the use of PRPP, the piezosurgery device and the diode laser has a positive effect: it helped to optimize reparative osteogenesis after filling post-surgical cavities and restore bone volume.

ANK1 inhibits malignant progression of osteosarcoma by promoting ferroptosis

PurposeOsteosarcoma (OS) is a primary bone tumor with high malignancy and poor prognosis. Ferroptosis plays a crucial role in OS. This study aimed to evaluate the effects of Ankyrin 1 (ANK1) on OS and to investigate its specific mechanisms.MethodsMicroarray datasets related to “osteosarcoma” were selected for this study. Relevant hub genes in OS were identified through bioinformatics analysis. Transfected U-2OS and MG-63 cells were used for in vitro experiments. The effects of ANK1 overexpression on cell viability, migration, and invasion were determined through CCK-8, wound healing, and transwell assays. An OS mouse model was established for the in vivo experiments. Hematoxylin-eosin staining and immunohistochemistry were conducted to observe the histological effects of ANK1 overexpression on mouse tumors. TUNEL staining was performed to evaluate apoptosis in mouse.ResultsThere were 159 common differentially expressed genes in the GSE16088 and GSE19276 datasets. The hub genes ANK1, AHSP, GYPB, GYPA, KEL, and ALAS2 were identified. Pan-cancer analysis verified that ANK1 was closely associated with cancer prognosis and immune infiltration. Furthermore, ANK1 overexpression inhibited the proliferation, migration, and invasion of OS cells and promoted ferroptosis, while ferroptosis inhibitor (fer-1) weakened these effects. Moreover, ANK1 overexpression suppressed tumor growth, promoted apoptosis, reduced the number of Ki67 positive cells, and elevated the number of caspase-3 positive cells in vivo.ConclusionsANK1 is a prognosis biomarker of OS that can alleviate the progression of OS by promoting ferroptosis.

A Chemotherapy-Photothermal synergistic system in bifunctional bone Scaffold: Tumor therapy and bone repair

Bone defect repair and tumor recurrence are the main challenges in the postoperative treatment of bone tumors. The incorporation of zoledronate (ZOL) into scaffolds presents a promising approach, attributed to its osteogenic and anti-tumor properties. However, there are still some unfavorable factors that make it difficult to eradicate tumor cells at the surgical site, including drug rapid release, the insufficient anti-tumor efficacy of ZOL and the multidrug resistance of chemotherapy. Herein, a novel nano drug delivery platform mesoporous silicon-coated graphene oxide (GO/MSN) and ZOL loaded nanoparticle (GO/MSN-ZOL) were developed. Then PLLA/ GO/MSN-ZOL scaffold that integrates photothermal therapy (PTT) and chemotherapy was fabricated using poly (L-lactic acid) as raw materials by selective laser sintering (SLS) technology. The GO not only imparted scaffold with photothermal properties for localized tumor cell ablation but also significantly enhanced its anti-tumor efficacy through synergistic effects in combination with chemotherapy. The mesoporous structure and large specific surface area of MSN contribute to the sustained release of ZOL. Additionally, GO could promote osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), which in combine with ZOL’s osteoclast inhibition, enhances the bone repair capacity. This study offers a straightforward and promising strategy for treating tumor-related bone defects.

OUTCOMES OF SHOULDER JOINT ENDOPROSTHETICS AFTER REMOVAL OF TUMORS IN THE HUMERUS

Introduction. The use of endoprostheses of the shoulder joint is possible with primary and secondary (metastatic) tumor lesions of the proximal part of the humerus. The possibility of using both individual oncological endoprostheses and modular oncological endoprostheses for tumors of the proximal part of the humerus is reported. Aim. To assess the effectiveness of restoring the function of the shoulder joint and upper limb and improving the patient's quality of life after shoulder joint arthroplasty for tumors of the proximal part of the humerus. Materials and methods. The results of the treatment of 27 patients who underwent shoulder arthroplasty in the conditions of the clinical departments of the "Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine" for tumors of the proximal part of the humerus from 2014 to 2024 were evaluated. Endoprosthesis was performed in 22 (81.5%) patients with primary tumors of the proximal part of the humerus and in 5 (18.5%) with metastatic tumors. Endoprosthesis of the shoulder joint was performed with individual oncological endoprostheses in 24 (88.9%) patients and modular oncological endoprostheses in 3 (11.1%) patients. Arthroplasty was primary in 25 (92.6%) patients and secondary in 2 (7.4%) patients. Results. During follow-up, 3 (11.1%) patients died with an average follow-up period of 10.3±1.9 months, the other 24 (88.9%) were alive, with an average follow-up period of 88.1±8.7 months. The overall frequency of complications in our study was 6 (22.2%) cases, 3 (11.1%) patients had an infectious complication in the late postoperative period after 12, 24 and 36 months, 1 (3.7%) patient had aseptic loosening of the leg of the endoprosthesis after 36 months, in 2 (7.4%) patients after 5 and 6 months, dislocation of the head of the endoprosthesis from the joint cavity was noted. Local tumor recurrence was observed in 2 (7.4%) patients. The overall mean MSTS total limb functional outcome after shoulder arthroplasty for all 27 patients was 74.2%, and of the 24 patients who survived, the mean limb functional outcome after shoulder arthroplasty was 78.4%. The patients' quality of life (according to the EORTQ-QLQ-С30 questionnaire) increased from 32 points in the preoperative period to 78 points after shoulder joint replacement. Conclusions. Endoprosthetics is a modern method for reconstructing bone segments in the surgical treatment of tumors of long bones in the limbs. This method allows for the replacement of bone defects of any size (volume) and length. Shoulder joint endoprosthetics within the framework of combination and multimodal treatment of primary and metastatic tumors of the proximal part of the humerus provides restoration of both shoulder joint functions and the upper limb as a whole, thereby improving the quality of life for this group of patients.

Network pharmacology, molecular docking, and molecular dynamics simulations shed light on the mechanism behind Gynostemma pentaphyllum's efficacy against osteosarcoma.

Osteosarcoma (OS) is the most common type of malignant bone tumor, that poses a serious threat to the lives and health of children and adolescents. Traditional Chinese medicines (TCM) have gained attention for treating OS because of their potent anti-cancer effects and fewer side effects. It is commonly understood that Gynostemma pentaphyllum (Thunb.) Makino (GP) exhibits inhibitory effects on most tumors. However, the knowledge of the systematic mechanisms involved is limited. In this study, the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) was searched to screen the effective ingredients and corresponding target genes of GP, and disease target databases were searched to identify relevant targets for OS. Venn analysis was used to visualize overlapping genes, which were further extracted using the protein-protein interaction network. R software was used to conduct gene ontology and Kyoto encyclopedia of genes and genomes pathway enrichment analysis, molecular docking and molecular dynamics simulation further validate the binding efficacy of potential therapeutic targets to compound molecules. In total, 161 and 1981 proteins were identified as target genes of GP and OS, respectively, and 104 overlapping genes were identified. Through analysis of the core subnetwork, 12 hub genes were identified, and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses revealed that the PI3K/Akt signaling pathway was the most significant. Molecular docking and molecular dynamics simulations show that a high affinity between quercetin and these targets, especially with the combination of TNF free energy (Δ Gbind) minimum, MM/PBSA and MM/GBSA is 42.85 kcal/mol, respectively, and 45.29 kcal/mol. The active ingredients Rhamnazin and Quercetin in Gypenoylum play a therapeutic role in OS through several key targets and pathways. This study provides ideas and references for further research on drug development.

Augmented Reality Navigation System (SIRIO) for Neuroprotection in Vertebral Tumoral Ablation.

(1) This study evaluates the impact of the CT-guided SIRIO augmented reality navigation system on the procedural efficacy and clinical outcomes of neuroprotection in vertebral thermal ablation (RTA) for primary and metastatic bone tumors. (2) Methods: A retrospective non-randomized analysis of 28 vertebral RTA procedures was conducted, comparing 12 SIRIO-assisted and 16 non-SIRIO-assisted procedures. The primary outcomes included dose-length product (DLP) and epidural dissection time. The secondary outcomes included technical success, complication rates, and pain scores at procedural time (VAS Time 0) and three months post-procedure (VAS Time 1). The statistical analyses included t-tests, Mann-Whitney U tests, and multiple regression. (3) Results: SIRIO-assisted procedures significantly reduced DLP (307.42 mGycm vs. 460.31 mGycm, p = 2.23 × 10-8) and procedural epidural dissection time (13.48 min vs. 32.26 min, p = 2.61 × 10-12) compared to non-SIRIO-assisted procedures. Multiple regression confirmed these reductions were significant (DLP: β = -162.38, p < 0.001; time: β = -18.25, p < 0.001). Pain scores (VAS Time 1) did not differ significantly between groups, and tumor type did not significantly influence outcomes. (4) Conclusions: The SIRIO system enhances neuroprotection efficacy and safety, reducing radiation dose and procedural time during spine tumoral ablation while maintaining consistent pain management outcomes.

Functional rehabilitation and long‑term efficacy of rotationplasty in pediatrics: A retrospective study.

Rehabilitation plays a critical role in the functional recovery of pediatric patients following rotationplasty for lower extremity malignant bone tumors. However, due to the limited number of cases and the unique characteristics of the surgery, there is a paucity of studies that have longitudinally evaluated the effect of rehabilitation strategies on long-term functional recovery after rotationplasty. Therefore, the present study aimed to identify an effective rehabilitation approach for pediatric patients undergoing rotationplasty for malignant bone tumors of the lower limb. Additionally, the study aimed to assess the effect of rehabilitation on long-term functional recovery and quality of life. A total of 12 patients were included in the current study, with a mean age at surgery of 6.58±1.73 years (range, 4-10 years). These patients underwent rotationplasty for malignant bone tumors of the lower extremity at the Fourth Medical Center of the Chinese People's Liberation Army General Hospital (Beijing, China) between March 2014 and March 2019. After surgery, patients underwent a 6-month postoperative rehabilitation programme, either on an outpatient or inpatient basis, with exercise therapy as the key training modality. The follow-up outcomes at 3, 6 and 12 months and at 3 and 5 years were recorded and analyzed, ensuring a comprehensive evaluation of long-term progress. The results demonstrated a gradual enhancement in functional performance and quality of life. Within a year of surgery, the patients displayed significant improvements in both functional recovery and quality of life, and all indicators remained stable 1 year later compared with those at 1 year post-surgery. More specifically, patients showed restored muscle strength and walking ability to normal levels, with a significant increase in muscle strength to 5/5. In addition, the study revealed that the mean distance covered in the 6-min walk test was 403.08±12.52 meters, while a duration of 8.83±0.72 sec was recorded in the timed up and go test. All patients have been continuously monitored up to date. The follow-up period for all patients ranged from 60 to 120 months, with a mean of 89.83±17.55 months. Overall, the findings indicated that the early postoperative period was a critical period for functional recovery, and that early postoperative rehabilitation interventions resulted in significant improvements to the rate and quality of functional recovery over time, thus further improving quality of life.

Diagnostic challenge of the brown tumors in developing country: A case series

Introduction and importanceBrown tumors are non-neoplastic reactive tissue with osteoclasts multinucleated giant cells, and vascular and proliferative fibrous tissue. Hemorrhage results in significant bone resorption caused by hyperparathyroidism. This study provides information about the diagnosis challenge for brown tumor cases. Case descriptionWe report four cases that experience pathological fractures with moderate pain, multiple lytic lesions, severe hypercalcemia, increased ALP (Alkaline Phosphatase), and PTH (Parathyroid Hormone). Abnormal parathyroid mass was found in ultrasound. A bone scan described increasing radio uptake in various bones, a whole body scan, or parathyroid scintigraphy with 99mTc-MIBI. Eventually, in all cases, the diagnosis of the brown tumor was confirmed through histopathological examination, which showed multiple nucleated giant cells with a deposit of hemosiderin pathognomonic for the brown tumor, and the diagnosis of primary hyperparathyroidism (PHPT) was confirmed in all cases. Clinical discussionThese cases show that initial misdiagnosis of brown tumors as other bone tumors. A definitive diagnosis of brown tumors requires more than just histological confirmation. A comprehensive evaluation encompassing laboratory tests, imaging studies, clinical symptoms, and a multidisciplinary orthopedic-oncology board discussion is essential. Observations show that treating hyperparathyroidism alleviates the osteolytic lesions caused by brown tumors, despite the lack of clinical guidelines. ConclusionBased on a review of the literature and our clinical experience, we recommend screening serum calcium, phosphorus, and PTH levels in patients presenting with multiple lesions and widespread bone pain. This screening aims to rule out multiple bone lesions caused by PHPT.

Imaging approach for jaw and maxillofacial bone tumors with updates from the 2022 World Health Organization classification.

Jaw and maxillofacial bone lesions encompass a wide variety of both neoplastic and non-neoplastic pathologies. These lesions can arise from various tissues, including bone, cartilage, and soft tissue, each presenting distinct challenges in diagnosis and treatment. While some pathologies exhibit characteristic imaging features that aid in diagnosis, many others are nonspecific. This overlap often necessitates a multimodal imaging approach, combining techniques such as radiographs, computed tomography, and magnetic resonance imaging to achieve a diagnosis or narrow the diagnostic considerations. This article provides a comprehensive review of the imaging approach to jaw and maxillofacial bone tumors, including updates on the 2022 World Health Organization classification of these tumors. The relevant anatomy of the jaw and dental structures that is important for accurate imaging interpretation is discussed.

Hereditary multiple exostoses with cervical spine involvement: a case report

Introduction and Importance: Hereditary multiple exostoses (HME) is a rare genetic disorder characterized by the formation of multiple benign bone tumors known as osteochondromas. Management of HME involves a multidisciplinary approach encompassing surgical expertise and genetic counseling. This case report highlights the significance of such an approach in optimizing outcomes for patients with HME, emphasizing the importance of individualized treatment strategies and future management. Case Presentation: We present the case of a 12-year-old male patient with a history of HME, who presented with symptoms including progressively enlarging and painful mass at the posterior aspect of his neck since last year. Surgical intervention was undertaken to address symptomatic lesions, focusing on preserving joint function and alleviating discomfort. The surgical approach involved careful consideration of lesion characteristics and their impact on surrounding structures. Clinical Discussion: The case shows the importance of a tailored surgical approach in managing symptomatic osteochondromas associated with HME, highlighting the need for careful consideration of lesion characteristics and their impact on joint function. By integrating surgical expertise with genetic counseling, clinicians can optimize outcomes while addressing familial implications and ensuring informed decision-making. Conclusion: This case report illustrates the significance of a multidisciplinary approach encompassing surgical intervention and genetic counseling in the management of hereditary multiple exostoses. Through individualized treatment strategies and informed decision-making, clinicians can optimize outcomes for patients with HME while providing comprehensive support and guidance for future management.

Consensus recommendations for systemic therapies in the management of relapsed Ewing sarcoma: A report from the National Ewing Sarcoma Tumor Board.

Ewing sarcoma (ES) is a malignant tumor of bone and soft tissue that most often occurs in children, adolescents, and young adults. Debate and controversy remain in the management of relapsed/refractory ES (RR-ES). The authors leveraged the expertise assembled by the National Ewing Sarcoma Tumor Board, a multidisciplinary virtual tumor board that meets monthly to discuss challenging cases of ES. In this review, they focus on select topics that apply to the management of patients with RR-ES. The specific topics covered include the initial approach of such patients and discussion of the goals of care, the role of molecular testing, chemotherapy regimens and novel agents to consider, the role of maintenance therapy, and the use of high-dose chemotherapy with autologous stem cell rescue. The data referenced are often limited to subgroup analyses and/or compiled from multiple sources. Although not intended to replace the clinical judgement of treating physicians, these guidelines are intended to support clinicians and provide some clarity and recommendations for the management of patients with RR-ES. PLAIN LANGUAGE SUMMARY: Ewing sarcoma (ES) is a bone and soft tissue cancer that most often occurs in teenagers and young adults. This article uses the experience of the National Ewing Sarcoma Tumor Board, a multi-institution, multidisciplinary virtual tumor board that meets monthly to discuss challenging cases of ES and to address questions related to the treatment of patients with relapsed ES. Although not intended to replace the clinical judgement of treating physicians and limited by available data, these consensus recommendations will support clinicians who treat patients with this challenging malignancy, made even more difficult when it recurs.

Multi-institutional prospective observational study of radiotherapy for metastatic bone tumor.

Purpose of this study is to evaluate patient characteristics, treatments and outcomes in bone metastasis radiotherapy practice. Patients for whom radiotherapy for bone metastasis was planned at 26 institutions in Japan between December 2020 and March 2021 were consecutively registered in this prospective, observational study. Study measures included patient characteristics, pain relief, skeletal-related events (SREs), overall survival and incidence of radiation-related adverse events. Pain was evaluated using a numerical rating scale (NRS) from 0 to 10. Irradiated dose was analyzed by the biologically effective dose (BED) assuming α/β = 10. Overall, 232 patients were registered; 224 patients and 302 lesions were fully analyzed. Eastern Cooperative Oncology Group Performance Status was 0/1/2/3/4 in 23%/38%/22%/13%/4%; 59% of patients had spinal metastases and 84% had painful lesions (NRS ≥ 2). BED was <20Gy (in 27%), 20-30Gy (24%), 30-40Gy (36%) and ≥ 40Gy (13%); 9% of patients were treated by stereotactic body radiotherapy. Grade 3 adverse events occurred in 4% and no grade 4-5 toxicity was reported. Pain relief was achieved in 52% at 2months. BED is not related to pain relief. The cumulative incidence of SREs was 6.5% (95% confidence interval (CI) 3.1-9.9) at 6months; no factors were significantly associated with SREs. With spinal lesions, 18% of patients were not ambulatory at baseline and 50% of evaluable patients in this group could walk at 2months. The 6-month overall survival rate was 70.2% (95% CI 64.2-76.9%). In conclusion, we report real-world details of radiotherapy in bone metastasis.

Outcome of Endoprosthetic Hip Reconstruction Following Resection of Malignant Bone Tumors.

Over the past few decades, tumor arthroplasty has evolved into an established therapeutic approach for addressing bone defects following tumor resection in the extremities. As the diagnosis has a significant impact on patients' lives, it is important to give clear expectations for functional recovery. Therefore, we investigated both the functional outcomes and the quality of life (QoL) after tumor arthroplasty for malignant hip tumors. This retrospective study included patients who had undergone resections of malignant hip tumors with consecutive modular hip arthroplasty between 2010 and 2018. Demographics, tumor entity, and complications stemming from both tumors and treatments were evaluated through the analysis of medical records and perioperative records. The assessment of functional outcomes was conducted with the following patient-reported outcome measures (PROMs): the Harris Hip Score (HHS), Musculoskeletal Tumor Society Score (MSTS), and the Short Form Survey 36 (SF-36). Furthermore, we performed subgroup analysis in two groups: one divided into survivors and non-survivors, as well as younger individuals (<57 years) and older individuals (>57 years). A total of 30 patients were included in the study. At the time of follow-up, 19 patients were deceased. The average duration of follow-up was 3.2 (±2.51) years. The average age at the time of surgery was 60.3 (±15.20) years. Notably, there were no cases of amputation reported (0%). Five cases of implant failure were identified (16.67%). Among these, one was attributed to infection (3.3%), while four resulted from aseptic loosening (13.3%). In terms of functional outcomes, MSTS indicated good results (18 ± 7; range: 7-28; 60%), and the HHS demonstrated moderate outcomes (75.3%). Younger survivors (<57 years) exhibited notably superior results in terms of both the MSTS and physical functioning in the SF-36 (p = 0.03). In summary, this study shows declining tumor arthroplasty-related complications and satisfying functional outcomes as well as QoL. Noteworthy aspects include the relatively low rates of amputation and local tumor recurrences, which significantly favor the selection of appropriate therapeutic options. Moreover, the findings underscore the substantial impact of patients' age on overall functionality and engagement in daily activities.

Research trends of bone tumor treatment with 3D printing technology from 2013 to 2022: a bibliometric analysis

ObjectiveBibliometrics was employed in this study to determine the research trends in the worldwide application of 3D printing technology to treat bone tumors over the previous 10 years.MethodsPublished from 2013 to 2022, the papers related to bone tumors treated with 3D printing were located in Web of Science Core Collection (WoSCC), PubMed, and Scopus. The screened articles were included in this bibliometric study. From these papers in WoSCC, information on annual publications, journals, keywords, countries, authors, institutions, and cited references were extracted and visualized with CiteSpace (version 6.1.R6) software to investigate the state of bone tumor treatment using 3D printing as well as research hotspots. The Carrot2 online visualization tool and Vosviewer software (version 1.6.20) were employed to visualize the publications from PubMed and Scopus, respectively, in order to ascertain the most popular research topics from both databases.ResultsA total of 606, 233, and 364 publications were obtained from WoSCC, PubMed, and Scopus, respectively, between the years 2013 and 2022. In WoSCC, the peak number of publications was found in 2021, with 145 publications published. Acta Biomaterialia (11 publications) and World Neurosurgery (10 publications) were the most prolific journals, and Biomaterials was the journal cited the most (244 times). Yong Zhou was the most productive author with 14 publications, while Kwok-Chuen Wong (69 citations) and William F Enneking, (69 citations) possessed the most citations. The country with the largest quantity of publications was China (207). Among all institutions, Shanghai Jiao Tong University produced the most publications (29). Rapid prototyping was the keyword with the strongest citation burst (4.73). ‘Reconstruction’, ‘surgery’, ‘resection’, and ‘design’ caught the significant attention of researchers. 3D-printed materials, pelvic reconstruction, mandibular reconstruction, computer-assisted surgical techniques, photothermal therapy, and in vitro experiments were recognized as hot subjects and trends in current research. The most frequently occurring topics in Scopus are not significantly different from those found in WoSCC. The most prevalent research areas in PubMed encompass implant, patient-specific, bioceramic, models, and pelvic.

Prognostic factors and outcome of relapsed/progressive pediatric Ewing sarcoma: single-center 10-year experience

BackgroundEwing sarcoma (ES) is the second most common primary malignant bone tumor in children and adolescents. Despite more intensive chemotherapy regimens and improved local control therapy, there is still a considerable rate of recurrent/progressive disease.MethodsA retrospective study of 50 relapsed/progressive ES patients who were treated at the National Cancer Institute (NCI), Cairo University, during the period from 1st of January 2008 to the end of December 2018, to assess different prognostic variables and disease outcomes.ResultsOut of fifty eligible cases, 32 patients (64%) had disease recurrence, and 18 (36%) developed disease progression on treatment. The median follow-up period was 7.4 months. The median overall survival (OS) was 7.5 months, and the cumulative OS was 64% at 6 months and 32.6% at 1 year. The cumulative event-free survival (EFS) was 41.3% at 6 months and 22.3% at 1 year. Patients with disease recurrence had better OS and EFS than patients with disease progression (p = 0.019). Patients who underwent local control at relapse/progression had a significantly better outcome than patients who received chemotherapy only (p < 0.001). Recurrence > 2 years from initial diagnosis was the only independent predictor of better survival outcome.ConclusionsPatients with relapsing/progressive ES portended a poor outcome, with disease progression on treatment faring worse than relapse. Better outcome was observed in patients who experienced recurrence > 2 years after diagnosis, patients with disease recurrence rather than disease progression on treatment, and patients who underwent local control along with intensive chemotherapy.

Ezetimibe Inhibits Cell Viability and Invasion by Suppressing PI3K/AKT Signaling Pathway in Human Osteosarcoma Cells

Introduction: Osteosarcoma is one of the most prevalent malignant bone tumors with a poor overall prognosis and mainly happens in children and adolescents. Current therapy strategies still possess a lot of limitations, and new and efficient strategies are required. Ezetimibe was previously reported to have its anti-tumor effect in various tumors, but the investigation of Ezetimibe on osteosarcoma is still limited. Aims: This study explores whether ezetimibe could exert an anti-tumor effect on human osteosarcoma cell lines, U2OS, and Saos-2. Methods: The effect of ezetimibe on the proliferation of osteosarcoma was explored by CCK-8 and colony formation assay. The role of ezetimibe on osteosarcoma cell migration and invasion was explored by wound healing assay and transwell assay. The role of ezetimibe on osteosarcoma cell apoptosis was explored by PI/Annexin V analysis. In addition, a western blot was performed to verify the phenotype. Results: The flow cytometry assay indicated that ezetimibe could promote osteosarcoma apoptosis. Western blot assay further demonstrated the effect of ezetimibe on proliferation, migration, invasion and apoptosis- related proteins. Finally, the deep anti-tumor effect of ezetimibe contributed to suppressing the PI3K/AKT signaling pathway. Conclusion: Present data indicated that ezetimibe has an antitumor effect on osteosarcoma and could be considered a future osteosarcoma treatment.