bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overall survival after perioperative chemotherapy in the management of pulmonary metastasis in osteosarcoma.
Authors: Siddiqui Zeba , Delisle Megan E , Srikanthan Amirrtha , Wang Ying 
Published: June 2021

e23508 Background: Pulmonary metastasectomy is performed on a select cohort of patients with advanced osteosarcoma with the potential for long term survival. However, evidence on peri-operative chemotherapy at time of metastasectomy is not completely understood and difficult to summarize without a systematic examination of existing literature. The purpose of this project is to perform a meta-analysis of existing studies to determine overall survival (OS) and prognostic factors in adults and children with advanced and recurrent osteosarcoma receiving chemotherapy around time of metastasectomy. Methods: We reviewed survival studies conducted in children and adults with advanced and recurrent osteosarcoma who undergo pulmonary metastasectomy published in English with more than 5 patients. The primary outcome was overall survival. Literature searches were performed in multiple electronic databases including Ovid MEDLINE (1946 to present), Ovid EMBASE (1974 to present), Web of Science, and Cochrane Library. Two investigators independently screened all citations, abstracts, and full-text articles. Results: 24 out of 80 observational studies between 1977 to 2018 were included. 2146 patients were studied of which 987 underwent pulmonary metastasectomy for osteosarcoma. 822 patients received perioperative chemotherapy in this setting. No randomized controlled trials were identified. Studies included patients from Asia, Africa, Europe, and North America. The median OS ranged between 20 to 90 months. 5-year OS ranged between 15 to 63%. Factors associated with survival included: age, number of lesions, disease free interval, time of development of metastases, number of lesions and laterality of pulmonary disease. Conclusions: Overall survival in study has a significant range. Factors influencing survival included intrinsic factors such as patient age and disease characteristics, as well as extrinsic factors such as evolution of chemotherapy regimen over the past four decades. The main limitations are related to the inherently low-quality evidence as a result of lack of randomized controlled trials. More comprehensive data is needed to guide shared decision making in this area.
Various treatment options for the management of Campanacci III giant cell bone tumor.
Authors: Gillani Syed Faraz-ul-Hassan Shah , Taqi Muhammad , Haq Muhammad Ayyaz Ul , Aslam Anam , Masood Faisal , Haider Mobeen Zaka , Mushtaq Muhammad Umair 
Published: June 2021

e23509 Background: To assess the treatment effectiveness of Campanacci III giant cell bone tumours. Methods: This prospective cohort study was done using a non-probability purposive sampling technique in the orthopaedic surgery and traumatology unit-I department from February 2013 to October 2017. The sample size of 21 patients aged 33 to 60year Campanacci III giant cell bone tumour diagnosed on biopsy were included, and all patients with uncontrolled diabetes mellitus, decompensated liver disease, chronic renal failure, previously treated for giant cell tumours and malignant transformation were excluded. Treatment options included wide margin excision with fibular vascular graft with plating, mega prosthesis, and chirolin prosthesis. Treatment effectiveness was observed in terms of superficial & deep infection, limb length discrepancy, implant failure and function using musculoskeletal tumour society rating scale (MSTS). Follow-p of the patients was five years. All patients were followed up for six months in the first year and yearly till five years. Results: Out of the total 21 patients, male were 11 (52.4%) and female were 10 (47.6%). The mean age of the patients was 34.8±14.6 years, with a median age was 30year. Four (19.1%) had proximal humerus, o5 (23.8% had distal radius, 09 (42.8% had distal femur, and 03 (14.3%) had proximal thigh involvement. The MSTS was 21.8±6.8 with a median score of 22 till the last follow-up. Kaplan Meier curve was plotted, and median survival rate was 50% at 54 months for the patients treated with fibular vascular graft, 57 months for mega prosthesis and 58 months for the patients treated with chirolin prosthesis. Conclusions: Treatment of Campanacci III with mega prosthesis, fibular vascular graft and chirolin prosthesis is a good outcome except with implant failure in mega prosthesis and limb length inequality with fibular vascular grafts. [Table: see text]
Role of biogenetic markers in differentiation and prognosis of giant cell tumor: A systemic review.
Authors: Taqi Muhammad , Haider Mobeen Zaka , Tariq Mishaal , Gillani Syed Faraz-ul-Hassan Shah , Ali Munawar , Zamani Zarlakhta , Rasool Muhammad Haseeb ul , Shahzad Moazzam , Mushtaq Muhammad Umair 
Published: June 2021

e23514 Background: Giant cell tumor (GCT) is a locally aggressive bone tumor. Early diagnosis and potential for recurrence are often difficult to assess due to a lack of bio-genetic markers and radiographic findings overlap with other osteolytic lesions. The purpose of this study is to explore biological and genetic markers that can be used for detection, differentiation, recurrence, and prognosis of GCT. Methods: We conducted a literature review including 24 articles out of 1568 articles, summarizing the role of biogenetic markers in the prognosis of GCT. Results: P63 is 98.6% sensitive and relatively specific for GCT as compared to other multinucleated giant cells containing neoplasms. MDM2(Mouse double minute 2 homolog), IGF1(Insulin-like growth factor 1), STAT1(Signal transducer and activator of transcription 1), and RAC1(Ras-related C3 botulinum toxin substrate 1) are associated with GCT recurrence. Increased expression of proteins like STAT5B, GRB2, and OXSR1 are related to a higher probability of metastasis. Neutrophil to lymphocyte ratio > 2.70, platelets to lymphocyte > 215.80, lymphocyte to monocyte ≤ 2.80, and AGR albumin to globulin < 1.50 ratio were significantly associated with decreased disease-free survival (DFS) (p < 0.05). Large amounts of osteoclast-related mRNA in GCTs (P < 0.05) are associated with the grade of bone resorption. We propose that subarticular primary malignant bone sarcoma with H3.3 mutations represent true malignant GCTB. IMP3 and IGF2 might be potential biomarkers in regulating the angiogenesis of GCT spine and predicting the patients’ prognosis. Conclusions: This review study has shown serological markers are significant in determining the diagnosis, differentiation, prognosis, and recurrence of GCT, which can be added to tumor work-up for definitive diagnosis and prognosis. [Table: see text]
Comorbidity: Chronic neurogenic pain affects malignant growth and changes balance of neurosteroids in brain of rats.
Authors: Pogorelova Yulia A. , Surikova Ekaterina I. , Frantsiyants Elena M. , Bandovkina Valeria A. , Kaplieva Irina V. , Neskubina Irina V. , Cheryarina Natalia D. , Kotieva Inga Movlievna , Shalashnaya Elena V. , Trepitaki Lidia K. , Pozdnyakova Viktoria V. 
Published: June 2021

e23516 Background: Sex steroids in the brain regulate neurogenesis and the body's response to stress. Chronic neurogenic pain (CNP) and the tumor growth are stress factors that often accompany each other. The purpose of the study was to analyze levels of sex steroid hormones in white matter of the brain of rats with tumor development in presence of CNP. Methods: The study included white outbred male rats (n = 74). In the main groups, a CNP model was created by bilateral sciatic nerve ligation, and after 45 days, M1 sarcoma was transplanted subcutaneously (n = 11) or into the subclavian vein (n = 11). Two comparison groups (each n = 13) included sham operated animals with M1 sarcoma transplanted subcutaneously or into the subclavian vein. Control groups (each n = 13) included animals with CNP or sham operated rats. Levels of testosterone (T), estrone (E1), estradiol (E2), estriol (E3) and progesterone (P4) were measured by ELISA (Cusabio, China) in the brain tissues obtained on day 21 of the tumor growth. Results: Tumors transplanted subcutaneously with and without CNP grew in 100% of animals. Tumor volumes were 1.5 times (p<0.05) greater in animals with CNP, compared with rats without CNP, while the survival in the groups was similar. Levels of all studied hormones, except for E1, in the brain tissue in subcutaneous sarcoma growth were lower in presence of CNP than without it: T and E3–on average by 1.4 times (p<0.05), E2 and P4–by 3.5 times (p<0.05). In rats with intravenous transplantation of M1, tumor nodes in the lungs were registered only in rats with CNP, and the survival of animals was 36 days shorter (p<0.05) than in rats of the corresponding control group. Such specificity of selective neoplastic growth in the pulmonary tissue was combined with lower cerebral T and E3 levels than in the corresponding control–on average by 1.4 times (p<0.05), E2–by 7.2 times, and higher levels of E1–by 1.3 (p<0.05) and P4–by 2.0 times, compared to animals which did not develop the neoplastic process in the lungs without pain. Conclusions: The presence of CNP stimulates the growth of M1 sarcoma in standard subcutaneous inoculation and allows the development of tumors in the lung in intravenous inoculation. The specificity of malignant growth in presence of CNP is accompanied by changes in the brain levels of neurosteroids in rats.
Simultaneous stimulation of growth of malignant tumors with epithelioid and sarcomatous nature in experiment.
Authors: Kaplieva Irina V. , Frantsiyants Elena M. , Trepitaki Lidia K. , Surikova Ekaterina I. , Bandovkina Valeria A. , Neskubina Irina V. , Kotieva Inga Movlievna , Shumarin Konstantin A. , Zhukova Galina V. 
Published: June 2021

e23517 Background: The relevance of studying multiple primary malignant tumors (MPMTs) is determined by poor understanding of their pathogenesis. Our purpose was to create an experimental model of synchronous MPMTs with the stimulation of malignant growth of tumors with different histostructure. Methods: The study included 20 male BALB/c Nude mice. The main group included mice with simultaneous subcutaneous inoculation of tumors: murine B16/F10 melanoma (0.5 ml of suspension diluted 1:20 in saline solution) below the left scapula and rat sarcoma 45 (0.5 million tumor cells in 0.5 ml of saline solution) below the right scapula. Control groups included males with melanoma or sarcoma inoculated at the same dosage and volume as in the main group. Results: In the model of synchronous MPMTs, tumors appeared faster than in controls: melanoma–by 3 times, sarcoma–by 2 times; their volume was larger: melanoma–by 2.2 times, sarcoma–by 3.2 times. Melanoma metastasized, in addition to typical sites (the lungs, spleen, liver), into sarcoma 45 to the side adjacent to the chest, under the tumor node. The survival of mice with MPMTs was lower. The morphological structure of melanoma metastasis into sarcoma 45 was represented by large lamellar-rounded epithelium-like cells of melanosarcoma type with transparent cytoplasm and nuclei with a high frequency of pathological mitosis figures. Bundles of elongated spindle-shaped melanocytes with processes of the cytoplasm were determined in some melanoma areas, as well as alveolar and concentric structures. Conclusions: Synchronous subcutaneous inoculation of murine B16/F10 melanoma and rat sarcoma 45 to male BALB/c Nude mice increases their malignant potential due to an exchange of “structural information"; as a result, sarcoma acquires impulses of proliferative activity of melanoma, which, in turn, adapts and “mimics” a tumor into which it is going to metastasize.
Comparison of clinicopathological features and outcomes in patients with primary leiomyosarcoma of bone and soft tissue.
Authors: Blank Alan T. , Gusho Charles , Gitelis Steven 
Published: June 2021

e23526 Background: Leiomyosarcoma is a rare malignancy that may occur in bone. This investigation described the characteristics and outcomes of primary leiomyosarcoma of bone (PLB) compared to soft tissue leiomyosarcoma (SLMS). Methods: This study was a retrospective review using the Surveillance, Epidemiology, and End Results (SEER) database from 1975 to 2016. Continuous and categorial variables were described, and Cox regression were used to identify factors of prognostic significance. Results: Seven thousand five-hundred two patients met inclusion criteria. Seventy-four (1%) were PLB and 7428 (99%) were SLMS. On multivariable analysis for high-grade SLMS radiation (neoadjuvant: HR, 0.56; 95% CI, 0.4-0.8; p = 0.003, and adjuvant: HR, 0.75; 95% CI, 0.6-0.9; p = 0.008) and surgery (procedure specific) improved DSS, while age (HR, 1.013; 95% CI, 1.0-1.1; p < 0.001), tumor size greater than or equal to 5 cm (HR, 3.16; 95% CI, 2.3-4.2; p < 0.001), abdomen/pelvis/trunk/thorax tumors (HR, 1.31; 95% CI, 1.1-1.6; p = 0.006), and distant metastases at presentation (HR, 2.6; 95% CI, 2.1-3.3; p < 0.001) negatively influenced DSS. Conclusions: Radiation and surgery positively influence survival in high-grade SLMS while chemotherapy appears to have no benefit. Surgery alone appears to lower the mortality risk in PLB.
The role of ifosfamide-doxorubicin chemotherapy in the treatment histology-specific, high grade, locally advanced soft tissue sarcoma: A 14-year experience.
Authors: Goy Barry W 
Published: June 2021

e23529 Background: To compare long-term outcomes of high grade, locally advanced, primary soft tissue sarcoma (STS), using Ifosfamide-Doxorubicin vs local therapy alone, in histology-specific sarcomas. Methods: Retrospective analysis was performed on 127 patients from 2005 to 2018, who had STS of extremity or trunk, > 5cm, that were either Synovial Cell, Dedifferentiated Liposarcoma (DDL), Myxofibrosarcoma, Round Cell Liposarcoma (RCLS), Undifferentiated Pleomorphic Sarcoma (UPS), or Undifferentiated Sarcoma not otherwise specified (NOS), with central pathology review. Ifosfamide-doxorubicin was generally given neoadjuvant, followed by radiation and wide excision, with chemotherapy given in 38 patients, while 89 received local therapy alone. Multi-variable analysis of prognostic factors was performed, and local-recurrence-free-survival (LRFS), distant-metastases-free-survival (DMFS), disease-specific-survival (DSS), and overall-survival(OS) were estimated using Kaplan-Meier. Results: Median follow-up was 4.5 years. Younger age (p < 0.0001) and Synovial histology (p = 0.0002) had significantly higher rates of receiving chemotherapy. Size > 10cm and trunk location were poor prognostic features on multivariable analysis (MVA) affecting DMFS, DSS, and OS, while DDL histology had a more favorable effect; although size, trunk location, and DDL histology were not significantly different between treatment groups. Ifosfamide-Doxorubicin vs local therapy alone improved 5-year DMFS at 70.2% vs 49.5% ,p = 0.02, DSS 83.5% vs 57.9%, p = 0.009, and OS 80.6% vs 53.8%, p = 0.002. Sub-analysis of non-synovial histologies still showed a significant improvements in favor of chemotherapy in DMFS,(p = 0.04), DSS (p = 0.02), and OS (p = 0.003). Conclusions: Ifosfamide-Doxorubicin chemotherapy benefits younger patients with > 5cm, high grade, STS of the trunk or extremity, with histologies of Synovial Cell, DDL, Myxofibrosarcoma, RCLS, UPS, or Undifferentiated Sarcoma NOS.
Efficacy and safety of anlotinib combined with liposomal doxorubicin in first-line treatment of advanced soft-tissue sarcoma.
Authors: Sun Xin , Guo Wei , Zhang Ranxin , Xie Lu , Xu Jie 
Published: June 2021

e23530 Background: Anthracycline-based chemotherapy is the main first-line treatment option for advanced soft-tissue sarcoma (STS). Anlotinib has been approved for the treatment of STS by the Chinese agency. This study was performed to evaluate the efficacy and safety of Anlotinib combined with liposomal doxorubicin in first-line treatment of patients with advanced STS. Methods: This is a single-center, retrospective study. Eligible patients were those ≥14 years old, ECOG performance state of 0-1, with histologically confirmed locally advanced, unresectable or metastatic STS, previously untreated, with measurable disease by RECIST v1.1. All patients received Anlotinib (12mg once daily, 2 weeks on and 1 week off) and liposomal doxorubicin (40-50 mg/m2, IV, D1, every 3 weeks) until disease progression or unacceptable adverse events. The primary endpoint was progression-free survival (PFS). Disease control rate (DCR), objective response rate (ORR), and side effects were also calculated. Results: Between April 2019 and December 2020, 8 patients were evaluated, including 2 undifferentiated pleomorphic sarcoma, 1 liposarcoma, 4 fibrosarcomas, and 1 synovial sarcoma. The median age was 42 years. 2 patients (25%) achieved a confirmed partial response (PR) and 3(37.5%) had stable disease (SD). The ORR and DCR were 25% and 62.5% respectively. The median PFS was 11.3 months, and the PFS rate at 4 months was 50%. Treatment-related adverse events included hand-foot syndrome (3/8, 37.5%), pneumothorax (1/8, 12.5%), oral mucositis (2/8, 25%), epistaxis (2/8, 25%), hypertension (2/8, 25%), arrhythmias (1/8, 12.5%), and pharyngeal pain (1/8, 12.5%). Three patients experienced grade 3 or 4 adverse events, 2 hand-foot syndrome (2/8, 25%) and 1 pneumothorax (1/8, 12.5%). Conclusions: This study suggested that the combination of Anlotinib and liposomal doxorubicin might have anti-tumor activity and acceptable toxicity in first-line treatment of patients with advanced STS.
A retrospective study of anlotinib combined with adriamycin and ifosfamide in unresectable soft tissue sarcoma.
Authors: Long Zuoyao , Lu Yajie , Li Minghui , Chen Guojing , Li Jing , Fu Zhanli , Akbar Yunus , Zhang Hong-Mei , Wang Zhen 
Published: June 2021

e23542 Background: Soft tissue sarcoma (STS) is a group of malignant tumors with high heterogeneity that originates from mesenchymal tissue. Considering that the reliable anti-tumor efficiency of tyrosine kinase inhibitor (TKI), we attempted to combine the TKI and chemotherapy to observe the synergistic effect in STS. This study documented the result on the efficiency and safety of anlotinib+AI in 28 patients with unresectable STS. Methods: The key inclusion criteria of this retrospective study included: (a) age was 10-70 years; (b) histologically documented high-grade STS; (c) unresectable and sensitive to chemotherapy; (c) having measurable lesions according to RECIST 1.1; (d) haven’t received tyrosine kinase inhibitors; (e) adequate organ function and blood pressure. Patients were excluded when they had distal metastasis. Patients took 12mg of anlotinib once daily on a schedule of 2 weeks on and 1 week off, and received 20mg/m2/d of Adriamycin(A) and 3g/m2/d of ifosfamide(I) in the first three days. Four cycles after treatment, patients were evaluated to receive surgery or other therapies. The primary end points were objective response rate (ORR) and limb salvage rate, and other endpoints include PFS, disease control rate (DCR), rate of R0 resection and recurrence. Results: Finally, a total of 28 patients were eligible to analysis including 17 males. Mean age was 39.11±13.46. The pathological subtypes in the study were consist of fibrosarcoma (FS, n = 6), synovial sarcoma (SS, n = 6), myxoid liposarcoma (MLPS, n = 6), undifferentiated pleomorphic sarcoma (n = 4) and others (n = 6). Until the last follow-up, no CR or PD occurred. The best response of 8 patients (28.57%) were PR and others were SD (20/28, 71.43%). The ORR and DCR was 28.57% and 100.0% respectively. Additionally, the tumor regression of SS and MLPS were significantly than FS (p = 0.012，p = 0.042). Eventually, 24 patients received surgery including 19 of R0 resection, 3 of R2 resection and 2 of amputation. The rate of limb salvage and R0 resection was 91.67% (22/24) and 79.17% (19/24). The median PFS was 21 months (95%CI: 8.53-33.69 months). Only one patient had dead due to tumor progression with a OS of 10 months. All patients had experienced adverse events (AE, 100.0%). The most common grade 3-4 AE were leukopenia (57.14%), hypertension (14.29%) and hand-foot syndrome (7.14%). All AEs could be tolerated or relieved by expectant treatment. Conclusions: The results in our study revealed that anlotinib+AI could be an alternative strategy of unresectable soft tissue sarcoma.
Preoperative stereotactic ablative body radiotherapy with postoperative conventional irradiation of soft tissue sarcomas: Protocol overview with a preliminary safety report.
Authors: Ebert Mariia , Novikov Sergey , Zinovev Grigory , Gafton Georgy , Protsenko Svetlana , Gafton Ivan , Sinyachkin Mikhail 
Published: June 2021

e23546 Background: Preoperative radiotherapy in patients with soft tissue sarcomas is characterized by important advantages: high precision of dose delivery, reduction of tumour volume and implantation potential, induction of immunologic response. Postoperative irradiation is associated with a reduced risk of complication, and a comprehensive radiotherapy planning in accordance with the pathologic report. Combination of pre- and postoperative irradiation gives the opportunity to use the best of both methods. Methods: from 06.2018 to 01.2021 24 patients with soft tissue sarcomas of extremities were included in the protocol (NCT04330456) and 14 cases with at least 12 months follow-up were eligible for analysis. Preoperative stereotactic ablative body radiotherapy (SBRT) was performed as 5 fraction of 7 Gy with dose reduction (5 fractions of 5 Gy) on the margins of the tumor. Postoperative radiotherapy started 5-8 weeks after the surgery and was performed as standard compartmental irradiation in 25 fractions of 2Gy. Complications were determined according to CTCAE and wound complication scales. Results: Preoperative SBRT and subsequent radical resection with tumor free surgical margins were performed in all 14 cases. Primary wound closure was mentioned in all patients. Postoperative radiotherapy started 51.8 days (range 33-99 days) days after the surgery. With a relatively short follow-up of 21.5 (13-30) months, we recorded 2 cases (14%) of severe complications (Canadian sarcoma group criteria), and there were no local recurrences. Conclusions: Our preliminary results demonstrate that the combination of preoperative SBRT and postoperative conventional radiotherapy is feasible and does not increase the risk of postoperative complications. Clinical trial information: NCT04330456.