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

Computed tomography has been found to be a more accurate diagnostic tool in the analysis of brain metastases than radionuclide scanning. Of 1,100 patients studied by CT scan, 57 showed evidence of intracerebral metastasis, and 14 showed evidence of hydrocephalus. Density levels below that of normal brain tissue were found in cases of metastases from the lung (13), breast (7), melanoma (4), kidney (3), lymphoma (3), and nasopharynx (1); levels above normal were found in cases of metastases from melanoma (8), lung (3), colon (3), chorionic carcinoma (2), osteogenic sarcoma (1), and kidney (1).
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PMID:Computed tomography in metastatic disease of the brain. 94

Recent advances in the use of chemotherapy for treatment of osteosarcoma have altered out pessimism in this disease. Results are presented from 3 groups of investigators using different agents as adjuvant chemotherapy following immediately upon amputation of the primary. The Roswell Park Memorial Institute began a regime, immediately after amputation, of adriamycin 30 mg/M2 for 3 doses and given every 4-6 weeks. This study was subsequently expanded in a cooperative group (ALGB) and the results on 20 patients analyzed. At 19 months approximately 75 per cent are free of any pulmonary metastases compared with 10-25 per cent expected from amputation alone. Similar results have been obtained by other Centers using different chemotherapeutic agents. In Boston Children's Hospital high dose Methotrexate with citrovorum factor is used. In 12 of these patients local control of the primary by surgery was obtained and of these only 1 developed pulmonary metastases during an observation time of 23 months. At the M. D. Anderson Hospital multi-drug combinations were used including Cyclophosphamide, Vincristine, L-Phenylalamine Mustard and Adriamycin. They reported a survival rate of 55 per cent (10 out of 18). All of these neoplastic agents have toxic side effects but when carefully used these effects are minimized and the quality of life is quite good. Many questions must be answered by future controlled long term follow-up studies.
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PMID:Chemotherapy of osteosarcoma. 105 62

Regrettably amputation remains to the present day an essential part of treatment in osteosarcoma of the limb bones. Only by its inclusion in the therapeutic regime can the present best level of about 20 per cent survival be achieved in any large group of patients. Preliminary biopsy is essential and there is no evidence that it is harmful even if followed by a delay of many days before definitive treatment. In patients treated initially by radiotherapy, selective amputation some 6 months later only in patients free of metastases, carries just as good a prognosis for the group as a whole as initial primary amputation in all patients. This method, first described by Cade, is widely practiced in the United Kingdom and spares many patients who develop early metastases following initial radiotherapy from unnecessary mutilating surgery shortly before inevitable death. Local recurrence may follow retention of a femoral stump following amputation for osteosarcoma at the most common site in the lower femoral metaphysis. There are cogent arguments in favor of hip disarticulation in such patients although they do not include evidence of greater survival. The balance between the two procedures is finely drawn but is weighted in favor of disarticulation.
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PMID:The surgical management of primary osteosarcoma. 105 65

Forty-seven histologically confirmed cases of Ewing's tumour are reported, with typical age, sex and skeletal distributions. The disease-free survival curves are like those for osteosarcoma of corresponding types of bone, but with higher mortality. The two-year disease-free survival rates were 24 percent for tumours of long bones and 5 per cent for those of other bones. Osseous metastases were most frequent, although the lung was the commonest single site involved. There were secondary deposits in lymph nodes in nine patients, possibly also in four more with mediastinal enlargement. Although initially radiosensitive, one-third of tumours recurred locally, almost always with the appearance of metastases. Neither whole bone irradiation nor high dosage alone ensures complete control of the primary tumour, and it is suggested that recently reported improved results of treatment should be attributed to adjuvant multi-drug chemotherapy. Inadequate control of the primary tumour diminishes the chance of survival and for some sites radical operation merits reconsideration.
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PMID:Ewing's tumour. A study of behaviour and treatment in forty-seven cases. 105 45

The paper presents a detailed comparison of the anatomical distribution and frequency of clinically evident metastases in 152 cases of osteosarcoma, and autopsy findings in 43 cases. The behaviour of long bone tumours is contrasted with those arising elsewhere, which tend to metastasize less widely because of early death from effects of the primary tumour. In both clinical and autopsy series long bone tumours produced lung metastases (LM) in over 90% of patients dying with metastases, but the terminal frequency of extra-pulmonary metastases (EPM) rises from a clinical level of 33% to 83% at autopsy. There was little difference between tumours of the major long bones in the frequency of either LM or EPM, but EPM from the humerus tended to be fewer and sited above the diaphragm and from the femur below it. EPM most often involved other bones, notably vertebrae and pelvis. Not more than 10% of tumours invaded regional lymph nodes but terminally a quarter of the long bone tumours had metastasized to heart and abdomen. The infrequency of metastases in muscle was confirmed. The median time for LM was 5-6 months after starting treatment, for EPM 9-10. months. First metastases after 24 months were infrequent, especially in children. With delay in the appearance of metastases, whether LM or EPM, post-metastatic survival lengthened. Neither age, sex nor mode of treatment of the primary notably affected metastatic frequency, although recurrences were much more numerous when radiotherapy, even with high dosage, was the definitive treatment. Local recurrence usually appeared within 6-8 months and was shown to lead to increased frequency of osseous metastases. It is suggested that terminal dissemination may often be tertiary but not always from a pulmonary secondary.
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PMID:The metastatic patterns of osteosarcoma. 105 38

Dunn osteosarcoma cells injected i.v. into tumor-free isogeneic C3H/He mice resulted in artificial pulmonary metastases, which were treated by cyclophosphamide (100 mg/kg/day i.p. for 3 days) or single thoracic X-ray doses of 1500 rads either 1 or 14 days after tumor cell injection. Compared to untreated controls, reduction in lung colony number and increase in life-span for the 1-day metastases were 56 and 46% for radiated mice, and 100 and greater than 367% for cyclophosphamide-treated mice. Corresponding values for 14-day metastases were 42, 26, 85, and 98%, respectively. Nine of 44 mice bearing 1-day metastases treated by cyclophosphamide are surviving greater than 340 days after treatment. Both treatments resulted in the extension of life-span and reduction of the number of lung colonies, and, in both modalities, there was a reduced antitumor effectiveness when treatment was withheld until the disease was more advanced.
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PMID:Survival of mice with metastatic osteosarcoma treated by cyclophosphamide or radiotherapy. 105 4

The fact that primary and secondary tumors of bone may present identical appearances (isomorphism) in radiographs is due to the unspecific reaction to different diseases of bony tissue. Radiographic differential diagnosis has narrow limits. Interpretation must take account of localization and age of the patient. Two cases of osteoplastic metastases in long bones are described which look very much like osteogenic sarcoma. Some 20 observations of this kind have been collected from the literature. The factors causing primary and reactive proliferation of bone are analyzed in detail.
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PMID:[Isomorphism of primary and secondary tumors of bone in radiographs (author's transl)]. 106 Jan 58

Careful study of 40 cases of osteosarcoma without evidence of multifocal disease, pulmonary metastasis, or history of exposure to predisposing factors has given histologic evidence of microscopic foci of osteosarcoma separate from the primary focus of osteogenic sarcoma. These "skip" lesions are to all pathologic examination completely separate from the primary focus of osteogenic sarcoma. They are more often found proximal to the primary, both intraosseously and transarticularly. Histologically, these "skips" represent areas of osteosarcoma which in many cases are a less-differenitated form of the tumor. The natural history of such tumors with "skips" following ablative surgery is an increased incidence of local recurrence and subsequent pulmonary metastases.
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PMID:"Skip" metastases in osteosarcoma. 106 May 7

A study of 102 osteogenic sarcomas of the bone surface revealed that 79 were parosteal osteogenic sarcomas. Roentgenographically, these 79 were dense, lobulated lesions attached by a broad base to underlying bone, usually the lower femoral shaft. Histologically, they were low-grade osteosarcomas. The other 23 lesions (periosteal osteogenic sarcoma) usually involved the upper tibial shaft and presented as small radiolucent lesions on the surface, with formation of spicules of bone perpendicular to the bone shaft. Histologically, these 23 were relatively high-grade, predominantly chondroblastic osteogenic sarcomas. Thirteen of the 23 patients were males, and most were in the second decade of life. Of five patients who had excision of the tumor, two had recurrence. Seven of 13 patients who underwent amputation initially were alive without disease at last follow-up. Only 4 of the 23 patients have dies of metastatic disease.
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PMID:Periosteal osteogenic sarcoma. 106 59

A transplantable murine osteosarcoma is described. Following transplantation into a syngeneic mouse the tumor grows rapidly and kills the mouse with pulmonary metastases simulating human osteosarcoma. A cell-mediated antibody response is evoked in the host mouse as demonstrated by in vivo and in vitro tests. The number of pulmonary metastases may be decreased with adjunctive immunotherapy following excision of the primary tumor. Immunotherapeutic materials include BCG and isologous cells treated with Vibrio cholerae neuraminidase.
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PMID:Immunological studies in murine osteosarcoma. Immunogenicity, growth kinetics, and immunotherapy. 106 29


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