Abstract:
BACKGROUND:Osteosarcoma is a rare complication of Paget's disease with a very poor prognosis. Treatment is controversial: the older age of the patients affected by Paget's disease may limit the use of chemotherapy and axial involvement may limit the practicality of surgery. QUESTIONS/PURPOSES:The purposes of this study are (1) to report the survival in patients treated for osteosarcoma in Paget's disease; (2) to identify correlations between type of treatment and survival comparing our data with those in the literature; (3) to determine if the extent of Paget's disease and risk of malignant transformation are associated; (4) to assess if prognosis is related with site; and (5) to identify the variations of histologic subtypes of these osteosarcomas. METHODS:We retrospectively reviewed the medical records of 26 patients treated between 1961 and 2006 who had bone sarcoma arising from a site of Paget's disease. Twenty two of the 26 patients had surgery. In six surgery only was performed; three had surgery, adjuvant chemotherapy, and radiotherapy; one surgery and radiotherapy; 12 underwent surgery and chemotherapy, adjuvant in 10 patients and neoadjuvant in two; two had only radiotherapy and two had only chemotherapy. We performed survival analyses between various combinations of treatment. RESULTS:At last followup four patients had no evidence of disease (NED) at a minimum followup of 42.6 months (mean, 139 months; range, 42.6-257.4 months) and 22 died with disease (DWD) at a minimum time of 1 month (mean, 20.2 months; range, 1-84 months). One of the six patients (11%) treated with surgery only had NED at 10 years; the other five died from disease at a mean of 30 months. Three of 12 patients (25%) treated with surgery and chemotherapy are NED at a mean followup of 12 years; nine died of disease at a mean of 24 months. All patients treated without surgery died at a mean of 7.5 months (range, 1-13.7 months). CONCLUSIONS:Despite improvements in surgery and medical treatments the prognosis remains poor in patients with Paget's sarcoma.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Ruggieri P,Calabrò T,Montalti M,Mercuri Mdoi
10.1007/s11999-010-1473-7subject
Has Abstractpub_date
2010-11-01 00:00:00pages
2962-8issue
11eissn
0009-921Xissn
1528-1132journal_volume
468pub_type
杂志文章abstract::Movement between screw threads and bone inhibits bone formation, revascularization and remodeling of dead bone. Movement causes the screw to become enveloped by fibrous tissue in response to necrosis and resorption of adjacent dead cortical bone. This results in a radiologically discernible radiolucent "halo" about th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197509000-00032
更新日期:1975-09-01 00:00:00
abstract:BACKGROUND:Revision THA to treat recurrent instability can itself be complicated by recurrent instability, and when this occurs, this problem is difficult to treat. Some patients' THAs will continue to dislocate despite use of a constrained liner. One option in this difficult-to-treat group is conversion to a dual-mobi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999.0000000000000026
更新日期:2018-02-01 00:00:00
abstract::A 54-year-old female with chronic renal failure who had undergone renal homotransplantation and who was being maintained for 3 months on immunosuppressive therapy, developed Candida pyarthrosis of the hip. The patient posed a management problem because of the nephrotoxicity of the antibiotics required to control Candi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-07-01 00:00:00
abstract::With the use of a stereoscopic microscope, observations were made on the course of the proper digital nerve of the thumb on ten upper limbs in adult cadavers. By observation from the dorsal side after removal of the bone, it was possible to clearly see the ramification of the digital nerve from the subcutaneous tissue...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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更新日期:1985-09-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1280-1
更新日期:2010-07-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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更新日期:2000-08-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e3180dc8c35
更新日期:2007-11-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3530-0
更新日期:2014-06-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000141899.77580.3b
更新日期:2004-09-01 00:00:00
abstract::Although previously unreported in the orthopaedic literature, hepatocellular carcinoma metastasizes to bone in 2 to 20% of cases. The poor prognosis associated with this tumor often results in patient demise before the need for orthopaedic intervention. A liver transplant recipient with no known history of hepatocellu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1560-9
更新日期:2011-04-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000093922.26658.3c
更新日期:2003-10-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::Fifty-six adults (average age, 38 years) with active tuberculosis of the lumbar and lumbosacral spine were treated conservatively with triple chemotherapy for 12 to 18 months. The minimum followup was 3 years. Three methods of assessments of the chronologic changes of sagittal spinal deformity were used on lateral rad...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200205000-00007
更新日期:2002-05-01 00:00:00
abstract::One thousand one hundred sixty-nine elderly Japanese patients who sustained a hip fracture were observed prospectively. Ninety-two percent had operative fracture treatment. Hospital length of stay averaged 67 days; 81% of patients were discharged to their place of residence where they resided before sustaining the fra...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1998-03-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2214-2
更新日期:2012-07-01 00:00:00
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journal_title:Clinical orthopaedics and related research
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更新日期:2003-04-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Electron microscopic evaluation was investigated in surgical specimens of interdigital neuroma. Edema of the endoneureum, fibrosis beneath the perineurium, axonal degeneration and necrosis suggest nerve damage occurs secondary to mechanical impingement in the etiology of interdigital neuroma. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:T1ρ MRI has been shown feasible to detect the biochemical status of hip cartilage, but various region-of-interest strategies have been used, compromising the reproducibility and comparability between different institutions and studies. QUESTIONS/PURPOSES:The purposes of this study were (1) to determine repr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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更新日期:2017-04-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章
doi:10.1007/s11999-010-1510-6
更新日期:2011-03-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1409-2
更新日期:2010-11-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2206-2
更新日期:2012-05-01 00:00:00
abstract::Forty-three consecutive patients who did not have healing of tibial or femoral diaphyseal and metaphyseal fractures and osteotomies for at least 9 months after injury or surgery were examined prospectively for use of high-energy extracorporeal shock waves. Former treatment modalities (cast, external fixator, plate ost...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章
doi:10.1097/00003086-200106000-00014
更新日期:2001-06-01 00:00:00
abstract::Scoliosis screening has been practiced for nearly 50 years and has provided valuable knowledge about the prevalence and natural history of scoliosis. Early diagnosis allows for nonoperative treatment, like wearing an orthosis that has been shown to be effective by numerous outcome studies. Challenges in scoliosis scre...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
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更新日期:2005-05-01 00:00:00