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Query: UMLS:C0029463 (osteosarcoma)
 16,637 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Preservation of a limb without sacrifice of the principles of cancer surgery is desirable in young people with osteogenic sarcoma. At present amputation is generally regarded as the only well-established curative treatment for this condition. To determine whether en bloc resection with intensive chemotherapy is a realistic alternative to radical amputation and chemotherapy, 43 patients who underwent en bloc resection for osteogenic sarcoma of the distal femur (20 patients), proximal tibia (11 patients), shoulder girdle (11 patients) and fibula (1 patient) were studied. After tumour resection, chemotherapy and pulmonary resection 32 (74%) of the 43 patients are alive and 20 (67%) have no evidence of distant disease. Of the 38 patients without metastatic disease at the time of admission (5 were admitted with pulmonary metastases) 24 (63%) are alive without evidence of disease and without having had postoperative metastases.
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PMID:En bloc resection for osteogenic sarcoma. 27 Oct 35

At the Princess Margaret Hospital, Toronto, during the period 1960 to 1975, radiation therapy was given to 59 patients with Ewing's sarcoma without overt metastases. Over this period treatment was modified to include, as well as irradiation to the primary tumour, total body irradiation (TBI) and chemotherapy according to various regiments. The 5-year survival rate of 38% in 26% patients who received TBI suggests that this may be of value. In patients with osteogenic sarcoma preoperative irradiation was not found to be of value. Recently the resection of pulmonary metastases combined with chemotherapy has increased the survival rate. When the primary site makes resection impracticable, the response to irradiation and chemotherapy is encouraging. Three cases so treated are described.
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PMID:Radiation treatment of Ewing's sarcoma and osteogenic sarcoma. 27 Oct 36

Metastatic tumor to the lungs is one of the most important factors in the poor prognosis of primary osteosarcoma of bone. Until recently, pulmonary resection alone was the only therapeutic method available to salvage these patients. Previous investigators have reviewed a number of clinical and pathologic parameters which may possibly relate to the prognosis of osteosarcoma and the occurrence of pulmonary metastases. The pathologic features of these latter lesions have received little attention other than to state that they generally are less differentiated than the primary tumor. A review of multiple pulmonary nodules resected from 15 patients has demonstrated that 66% of all lesions were essentially identical to the primary tumor. The 5-year survival from the original amputation was 33% in this series; however, it was not possible to prognosticate a favorable outcome from the metastasis, a similar type of observation which has been made by others in relation to the primary osteosarcoma.
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PMID:Metastatic osteosarcoma to lung: a clinicopathologic study of surgical biopsies and resections. 27 Oct 38

This is a review of the experience at Memorial Hospital using chemotherapy combined with surgical excision for control of pulmonary metastases in osteogenic sarcoma. Effective multiple drug chemotherapy was able to control small deposits of osteogenic sarcoma in the lung, making surgical resection of residual visible nodules worthwhile. Surgical resection was most successful for solitary nodules or where multiple nodules were shrunk or at least prevented from growing by chemotherapy. Eight percent of these patients with pulmonary metastases initially or subsequently showed bilateral lung disease. When two or more nodules were found at th oracotomy, they were never confined to one lobe. For these reasons, wedge resections or segmental resections were the most commonly indicated procedures. Results justify an aggressive surgical approach to these lesions including multiple wedge resections of all lesions found at thoracotomy, chest wall resection and multiple bilateral thoracotomies. Chemotherapy alone cannot be expected to cure metastatic osteogenic sarcoma of the lung, but combined with surgical resection of residual disease the results are encouraging.
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PMID:Thoracotomy as adjuvant to chemotherapy in metastatic osteogenic sarcoma. 27 Dec 21

Metastases of osteosarcomas do not grow according to a simple exponential function, but rather according to a type of Gompertz' function where flattening with a tendency toward plateau formation sets in after a certain time. This deviation from an exponential growth type corresponds to a substantial increase in the initial tumor size--doubling time. The metastasis doubles in the period after its transfer faster than when it first becomes visible in an x-ray. Another important conclusion resulting from the use of the Gompertz model is the assumption of a tumor-specific maximum volume which cannot be exceeded over a period of infinite growth. For lung metastases of osteosarcoma this volume amounts to approximately 120 cm3. The critical volume which kills the host is, at 70 to 80 cm3, relatively close to this theoretical growth limit (only approximately one cell division below this limit). If a metastasis develops from a single cell, the number of divisions up to this point is approximately 46. Of these, 38 lie within the growth zone which is not visible via x-ray. Since cell-cycle specific agents (for example Vincristin and Methotrexate) have the greatest effect against rapidly proliferating tumors, these drugs (for example alkylantic drugs) are especially effective in the case of slowly proliferating neoplasms. Therefore, use of these drugs should be favored when the metastasis is visible in the x-ray. Since occasionally, particular when the primary tumor is still relatively small, metastasization may not necessarily have already taken place, radical operation of the primary tumor should be carried out as soon as possible. A preliminary irradiation of the primary tumor cannot prevent metastasization with certainty. Therefore delayed amputation should be avoided.
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PMID:[On the growth characteristics of human osseous sarcoma metastases: mathematical calculations and clinical consequences (author's transl)]. 27 86

Twelve consecutive unselected patients (aged 6 to 18 years) with osteogenic sarcoma underwent 19 thoracotomies for resection of pulmonary metastases. Wedge excisions of 41 metastatic nodules, one bilobectomy, and one pneumonectomy were performed. Six patients each required one thoracotomy, five patients underwent two thoracotomies, and one patient required three. Serious surgical complications were limited to one patient who required reoperation for closure of a bronchopleural fistula following bilobectomy. Initial pulmonary metastasis occurred 9 months (mean) after amputation (range 1 to 21 months). Complete excision of all identifiable metastatic tumor was possible in 17 of 19 thoracotomies. All patients received intensive cyclical chemotherapy after initial definitive amputation, after thoracotomy, or both. Tumor doubling time (TDT) during chemotherapy (mean 74 days) was significantly prolonged (p = 0.017) compared to TDT during intervals of no therapy (mean 22 days). Five patients received pulmonary radiotherapy prior to thoracotomy and five after thoracotomy. Four patients died during the observation period, having survived 10 to 30 months after amputation. Two patients are alive with known extrapulmonary metastases. Six patients are free of disease. The survival rate is 91.7 percent 1 year after amputation, 82.5 percent at 2 years, and 57.8 percent at 3 years. These results suggest improved survival when aggressive surgical resections of pulmonary metastases are combined with chemotherapy and radiotherapy. Thoracic surgical procedures in this group of patients are safe and associated with a low incidence of complications despite the potentially increased risks owing to antecedent chemotherapy and pulmonary irradiation.
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PMID:Pulmonary resection in children with metastatic osteogenic sarcoma: improved survival with surgery, chemotherapy, and irradiation. 27 31

BCG administered by the multiple-puncture technique has been used in a prospective, randomized study of the adjuvant treatment of patients with osteogenic sarcoma. Pulmonary granulomas were found in the lungs of four of five patients receiving BCG, that underwent thoracotomy for the diagnosis of pulmonary nodules within three weeks of the last BCG injection. Except for a single, foreign-body granuloma no pulmonary granulomas were seen in seven randomized patients who did not receive BCG. In addition, two patients receiving BCG had evidence of granulomas in bone marrow and in a mediastinal lymph node. BCG administered by the multiple-puncture technique is capable of causing granulomas at sites distant from that of the BCG application. BCG can cause pulmonary granulomas and these granulomas may be confused with pulmonary metastatic disease.
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PMID:Pulmonary granulomas induced by BCG. 27 92

Doubling time values of pulmonary metastases from soft tissue sarcomas were measured. Sixty metastases from 24 patients were measured 79 consecutive times, and, the values for 116 doubling times were calculated. Small volume metastases grew significantly faster (arithmetic mean 29.7 days) than large metastases (arithmetic mean 43.4 days). An assessment with comparative data obtained previously by measuring the doubling time values of pulmonary metastases from osteogenic sarcoma revealed similar growth characteristics. The possible involvment of identical control mechanisms operating in the growth process of pulmonary metastases in both soft tissues and osteogenic sarcomas are discussed.
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PMID:Actual volume doubling time values for pulmonary metastases from soft tissue sarcomas. 27 19

The latency period, success rate, and minimal cell inoculum size required for transplantation of continuously passaged human tumor lines into congenitally athymic (nude) mice, antilymphocyte serum (ALS)-treated congenitally athymic (nude) mice, and congenitally athymic-asplenic (lasat) mice were compared. The 11 tumor lines studied included examples of breast adenocarcinoma, transitional cell carcinoma, osteosarcoma, fibrosarcoma, Hodgkin's disease, malignant melanoma, and rhabdomyosarcoma. Of these 11 tumor lines, 3 were successfully transplanted into nude mice, compared to 5 of 10 tumor lines in ALS-treated nude mice and 9 of 11 lines in lasat mice. Moreover, the latency period was shorter and the minimal cell inoculum size was lower for lasat mice than for either nude or ALS-treated nude mice. Despite this enhancement of heterotransplantation into lasat mice and despite the growth of large local masses, no evidence of distant metastases was found.
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PMID:Enhancement of heterotransplanted human tumor graft survival in nude mice treated with antilymphocyte serum and in congenitally athymic-asplenic (Lasat) mice. 27 31

A case of osteosarcoma affecting the third metatarsal bone is submitted. Below-knee amputation was performed, but the patient developed pulmonary metastases and died 1 year after the operation. The six cases of osteosarcoma in the metarsal bones published so far are reviewed. The prognosis for cases with this localization does not appear to differ from that for osteosarcoma in general.
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PMID:Osteosarcoma of the metatarsal bones. Review of the literature and report of a case. 27 54


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