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Article ; Online: Biopsy Techniques for Musculoskeletal Tumors: Basic Principles and Specialized Techniques.

Mavrogenis, Andreas F / Altsitzioglou, Pavlos / Tsukamoto, Shinji / Errani, Costantino

2024 Volume 31, Issue 2, Page(s) 900–917

Abstract: Biopsy is a pivotal component in the diagnostic process of bone and soft tissue tumors. The objective is to obtain adequate tissue without compromising local tumor dissemination and the patient's survival. This review explores contemporary principles and ...

Abstract	Biopsy is a pivotal component in the diagnostic process of bone and soft tissue tumors. The objective is to obtain adequate tissue without compromising local tumor dissemination and the patient's survival. This review explores contemporary principles and practices in musculoskeletal biopsies, emphasizing the critical role of diagnostic accuracy while also delving into the evolving landscape of liquid biopsies as a promising alternative in the field. A thorough literature search was done in PubMed and Google Scholar as well as in physical books in libraries to summarize the available biopsy techniques for musculoskeletal tumors, discuss the available methods, risk factors, and complications, and to emphasize the challenges related to biopsies in oncology. Research articles that studied the basic principles and specialized techniques of biopsy techniques in tumor patients were deemed eligible. Their advantages and disadvantages, technical and pathophysiological mechanisms, and possible risks and complications were reviewed, summarized, and discussed. An inadequately executed biopsy may hinder diagnosis and subsequently impact treatment outcomes. All lesions should be approached with a presumption of malignancy until proven otherwise. Liquid biopsies have emerged as a potent non-invasive tool for analyzing tumor phenotype, progression, and drug resistance and guiding treatment decisions in bone sarcomas and metastases. Despite advancements, several barriers remain in biopsies, including challenges related to costs, scalability, reproducibility, and isolation methods. It is paramount that orthopedic oncologists work together with radiologists and pathologists to enhance diagnosis, patient outcomes, and healthcare costs.
MeSH term(s)	Humans ; Biopsy, Needle/methods ; Reproducibility of Results ; Bone Neoplasms ; Biopsy ; Soft Tissue Neoplasms ; Musculoskeletal Diseases
Language	English
Publishing date	2024-02-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol31020067
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Article ; Online: Artificial Nerve Conduit for Recurrent Laryngeal Nerve Reconstruction in Thyroid Surgery.

Watanabe, Akihito / Kimura, Yuki / Tsukamoto, Shinji / Taniguchi, Masanobu / Ito, Suguru

The Laryngoscope

2023 Volume 133, Issue 7, Page(s) 1773–1779

Abstract: Objective: Oncological reconstruction of the recurrent laryngeal nerve (RLN) is sometimes necessary for RLN invaded by thyroid cancer. There have been no case reports of RLN reconstruction using artificial nerve conduits, which are often used for ... ...

Abstract	Objective: Oncological reconstruction of the recurrent laryngeal nerve (RLN) is sometimes necessary for RLN invaded by thyroid cancer. There have been no case reports of RLN reconstruction using artificial nerve conduits, which are often used for peripheral nerves. In this study, we retrospectively evaluate the feasibility, safety, and efficacy of a collagen conduit with collagen filaments for RLN reconstruction cases at our hospital. Methods: Artificial nerve conduits were used in seven cases of RLN reconstruction. Two patients had preoperative unilateral vocal cord paralysis with severe vocal cord atrophy, and two had vocal cord paresis without atrophy. The remaining three patients had functional vocal cords before surgery that had to be resected via surgery due to thyroid cancer infiltration of the RLN. Reconstruction was performed using RENERVE®, which is a collagen conduit. Voice examination and laryngeal endoscopy were performed 1, 3, and 12 months after surgery. Results: There was no improvement in the phonetics of the two patients with vocal cord atrophy before surgery. In the remaining five cases, three with functional vocal cords improved to preoperative values, and two with vocal cord paresis improved to greater than preoperative values. Conclusion: We report the first case series using an artificial nerve conduit for human RLN reconstruction. In cases of RLN resection when the patient has good voice quality pre-operatively, reconstruction of the RLN using an artificial nerve may be a favorable option in cases where direct anastomosis or ansa cervicalis to RLN anastomosis cannot be performed. Level of evidence: 4 Laryngoscope, 133:1773-1779, 2023.
MeSH term(s)	Humans ; Recurrent Laryngeal Nerve ; Vocal Cord Paralysis/etiology ; Vocal Cord Paralysis/surgery ; Retrospective Studies ; Thyroid Neoplasms/pathology ; Atrophy/complications ; Thyroidectomy/adverse effects
Language	English
Publishing date	2023-03-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.30669
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Article ; Online: What's new in musculoskeletal oncology.

Errani, Costantino / Mavrogenis, Andreas F / Tsukamoto, Shinji

BMC musculoskeletal disorders

2021 Volume 22, Issue 1, Page(s) 704

Abstract: We reviewed the recent literature related to primary musculoskeletal tumors and metastatic bone tumors. With regard to primary bone tumors, computer navigation systems and three-dimensional-printed prostheses seem to be new treatment options, especially ... ...

Abstract	We reviewed the recent literature related to primary musculoskeletal tumors and metastatic bone tumors. With regard to primary bone tumors, computer navigation systems and three-dimensional-printed prostheses seem to be new treatment options, especially in challenging anatomical locations, such as the sacrum and pelvis. Regarding the treatment of giant cell tumor of bone, recent studies have suggested that denosumab administration is related to a higher local recurrence rate following curettage, but a lower local recurrence rate following en bloc resection. In addition, there was no difference in the local recurrence rate at five years after surgery between short-term and long-term denosumab therapy. With regard to soft tissue tumors, percutaneous cryoablation appears to be a new treatment option for extra-abdominal desmoid tumors, with encouraging results. Regarding soft tissue sarcomas, a negative surgical margin of < 1 mm is sufficient to control local recurrence. Pexidartinib seems to be a promising systemic therapy for the treatment of tenosynovial giant cell tumors for which surgery is not expected to improve the function of the affected limb. Finally, the life expectancy of patients is the most important factor in determining the optimal surgical procedure for patients with impending or pathological fractures of the long bone due to metastatic bone tumors. Elevated C-reactive protein level was found to be an independent poor prognostic factor at 1 year after surgery for long bone metastases.
MeSH term(s)	Bone Neoplasms/drug therapy ; Bone Neoplasms/surgery ; Curettage ; Fractures, Spontaneous ; Humans ; Neoplasm Recurrence, Local ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-08-17
Publishing country	England
Document type	Journal Article ; Review
ISSN	1471-2474
ISSN (online)	1471-2474
DOI	10.1186/s12891-021-04590-1
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Article ; Online: Current Concepts in the Treatment of Giant Cell Tumor of Bone: An Update.

Tsukamoto, Shinji / Mavrogenis, Andreas F / Masunaga, Tomoya / Honoki, Kanya / Fujii, Hiromasa / Kido, Akira / Tanaka, Yasuhito / Errani, Costantino

Current oncology (Toronto, Ont.)

2024 Volume 31, Issue 4, Page(s) 2112–2132

Abstract: Curettage is recommended for the treatment of Campanacci stages 1-2 giant cell tumor of bone (GCTB) in the extremities, pelvis, sacrum, and spine, without preoperative denosumab treatment. In the distal femur, bone chips and plate fixation are utilized ... ...

Abstract	Curettage is recommended for the treatment of Campanacci stages 1-2 giant cell tumor of bone (GCTB) in the extremities, pelvis, sacrum, and spine, without preoperative denosumab treatment. In the distal femur, bone chips and plate fixation are utilized to reduce damage to the subchondral bone and prevent pathological fracture, respectively. For local recurrence, re-curettage may be utilized when feasible. En bloc resection is an option for very aggressive Campanacci stage 3 GCTB in the extremities, pelvis, sacrum, and spine, combined with 1-3 doses of preoperative denosumab treatment. Denosumab monotherapy once every 3 months is currently the standard strategy for inoperable patients and those with metastatic GCTB. However, in case of tumor growth, a possible malignant transformation should be considered. Zoledronic acid appears to be as effective as denosumab; nevertheless, it is a more cost-effective option. Therefore, zoledronic acid may be an alternative treatment option, particularly in developing countries. Surgery is the mainstay treatment for malignant GCTB.
MeSH term(s)	Humans ; Giant Cell Tumor of Bone/drug therapy ; Bone Neoplasms/drug therapy ; Denosumab/therapeutic use ; Bone Density Conservation Agents/therapeutic use ; Zoledronic Acid/therapeutic use
Chemical Substances	Denosumab (4EQZ6YO2HI) ; Bone Density Conservation Agents ; Zoledronic Acid (6XC1PAD3KF)
Language	English
Publishing date	2024-04-08
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol31040157
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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Imaging Analyses of Bone Tumors.

Errani, Costantino / Tsukamoto, Shinji / Mavrogenis, Andreas F

JBJS reviews

2020 Volume 8, Issue 3, Page(s) e0077

Abstract: Despite the evolution in imaging, especially the introduction of advanced imaging technologies, radiographs still are the key for the initial assessment of a bone tumor. Important aspects to be considered in radiographs are the location, shape and size ... ...

Abstract	Despite the evolution in imaging, especially the introduction of advanced imaging technologies, radiographs still are the key for the initial assessment of a bone tumor. Important aspects to be considered in radiographs are the location, shape and size or volume, margins, periosteal reaction, and internal mineralization of the tumor's matrix; careful evaluation of these may provide for accurate diagnosis in >80% of cases. Computed tomography and magnetic resonance imaging are often diagnostic for lesions with typical findings such as the nidus of osteoid osteoma and bone destruction such as in Ewing sarcoma and lymphoma that may be difficult to detect with radiographs; they may also be used for surgical planning. Magnetic resonance imaging accurately determines the intraosseous extent and articular and vascular involvement by the tumor. This article summarizes the diagnostic accuracy of imaging analyses in bone tumors and emphasizes the specific radiographic findings for optimal radiographic diagnosis of the patients with these tumors.
MeSH term(s)	Bone Neoplasms/diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed
Language	English
Publishing date	2020-03-09
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2329-9185
ISSN (online)	2329-9185
DOI	10.2106/JBJS.RVW.19.00077
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Article: Current Concepts in the Treatment of Giant Cell Tumors of Bone.

Tsukamoto, Shinji / Mavrogenis, Andreas F / Kido, Akira / Errani, Costantino

Cancers

2021 Volume 13, Issue 15

Abstract: The 2020 World Health Organization classification defined giant cell tumors of bone (GCTBs) as intermediate malignant tumors. Since the mutated H3F3A was found to be a specific marker for GCTB, it has become very useful in diagnosing GCTB. Curettage is ... ...

Abstract	The 2020 World Health Organization classification defined giant cell tumors of bone (GCTBs) as intermediate malignant tumors. Since the mutated H3F3A was found to be a specific marker for GCTB, it has become very useful in diagnosing GCTB. Curettage is the most common treatment for GCTBs. Preoperative administration of denosumab makes curettage difficult and increases the risk of local recurrence. Curettage is recommended to achieve good functional outcomes, even for local recurrence. For pathological fractures, joints should be preserved as much as possible and curettage should be attempted. Preoperative administration of denosumab for pelvic and spinal GCTBs reduces extraosseous lesions, hardens the tumor, and facilitates en bloc resection. Nerve-sparing surgery after embolization is a possible treatment for sacral GCTBS. Denosumab therapy with or without embolization is indicated for inoperable pelvic, spinal, and sacral GCTBs. It is recommended to first observe lung metastases, then administer denosumab for growing lesions. Radiotherapy is associated with a risk of malignant transformation and should be limited to cases where surgery is impossible and denosumab, zoledronic acid, or embolization is not available. Local recurrence after 2 years or more should be indicative of malignant transformation. This review summarizes the treatment approaches for non-malignant and malignant GCTBs.
Language	English
Publishing date	2021-07-21
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers13153647
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Article ; Online: What's new in the management of metastatic bone disease.

Tsukamoto, Shinji / Errani, Costantino / Kido, Akira / Mavrogenis, Andreas F

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

2021 Volume 31, Issue 8, Page(s) 1547–1555

Abstract: Metastatic bone disease is a common complication of malignant tumours. As cancer treatment improves the overall survival of patients, the number of patients with bone metastases is expected to increase. The treatments for bone metastases include surgery, ...

Abstract	Metastatic bone disease is a common complication of malignant tumours. As cancer treatment improves the overall survival of patients, the number of patients with bone metastases is expected to increase. The treatments for bone metastases include surgery, radiotherapy, and bone-modifying agents, with patients with a short expected prognosis requiring less invasive treatment. Patients with metastatic bone disease show greatly varying primary tumour histology, metastases sites and numbers, and comorbidities. Therefore, randomised clinical trials are indispensable to compare treatments for these patients. This editorial reviews recent findings on the diagnosis and prognosis prediction and discusses the current treatment of patients with metastatic bone disease.
MeSH term(s)	Bone Neoplasms/secondary ; Bone Neoplasms/therapy ; Bone and Bones ; Humans ; Prognosis
Language	English
Publishing date	2021-10-13
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	1231084-0
ISSN	1432-1068 ; 1633-8065 ; 0948-4817 ; 0940-3264
ISSN (online)	1432-1068
ISSN	1633-8065 ; 0948-4817 ; 0940-3264
DOI	10.1007/s00590-021-03136-4
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Article: Intercalary reconstruction following resection of diaphyseal bone tumors: A systematic review.

Errani, Costantino / Tsukamoto, Shinji / Almunhaisen, Nusaibah / Mavrogenis, Andreas / Donati, Davide

Journal of clinical orthopaedics and trauma

2021 Volume 19, Page(s) 1–10

Abstract: Introduction: The options for the reconstruction of diaphyseal defects following the resection of bone tumors include biological or prosthetic implants. The purpose of our study was to evaluate different types of intercalary reconstruction techniques, ... ...

Abstract	Introduction: The options for the reconstruction of diaphyseal defects following the resection of bone tumors include biological or prosthetic implants. The purpose of our study was to evaluate different types of intercalary reconstruction techniques, including massive bone allograft, extracorporeal devitalized autograft, vascularized free fibula, and modular prosthesis. Methods: We performed a systematic review of articles using the terms diaphyseal bone tumor and intercalary reconstruction. All the studies reporting the non-oncological complications such as infection, nonunion and fracture of the intercalary reconstructions were included. We excluded articles published before 2000 or did not involve humans in the study. Case reports, reviews, technique notes and opinion articles were also excluded based on the abstracts. Thirty-three articles included in this review were then studied to evaluate failure rates, complications and functional outcome of different surgical intercalary reconstruction techniques. Results: Nonunion rates of allograft ranged 6%-43%, while aseptic loosening rates of modular prosthesis ranged 0%-33%. Nonunion rates of allograft alone and allograft with a vascularized fibula graft ranged 6%-43% and 0%-33%, respectively. Fracture rates of allograft alone and allograft with a vascularized fibula graft ranged 7%-45% and 0%-44%, respectively. Infection rates of allograft alone and allograft with a vascularized fibula graft ranged 0%-28% and 0%-17%, respectively. All of the allograft (range: 67%-92%), extracorporeal devitalized autograft including irradiation (87%), autoclaving (70%), pasteurization (88%), low-heat (90%) or freezing with liquid nitrogen (90%), and modular prosthesis (range: 77%-93%) had similar Musculoskeletal Tumor Society functional scores. Addition of a vascularized fibula graft to allograft did not affect functional outcome [allograft with a vascularized fibula graft (range: 86%-94%) vs. allograft alone (range: 67%-92%)]. Conclusion: Aseptic loosening rates of modular prosthesis seem to be less than nonunion rates of allograft. Adding a vascularized fibula graft to allograft seems to increase bone union rate and reduce the risk of fractures and infections, though a vascularized fibula graft needs longer surgical time and has the disadvantage of donor site morbidity. These various intercalary reconstruction techniques with or without a vascularized fibula autograft had similar functional outcome.
Language	English
Publishing date	2021-05-07
Publishing country	India
Document type	Journal Article
ZDB-ID	2596956-0
ISSN	2213-3445 ; 0976-5662
ISSN (online)	2213-3445
ISSN	0976-5662
DOI	10.1016/j.jcot.2021.04.033
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Article: The Prognostic Value of the Serum Level of C-Reactive Protein for Survival of Children with Ewing's Sarcoma.

Errani, Costantino / Traversari, Matteo / Cosentino, Monica / Manfrini, Marco / Basoli, Stefano / Tsukamoto, Shinji / Mavrogenis, Andreas F / Bordini, Barbara / Donati, Davide Maria

Cancers

2023 Volume 15, Issue 5

Abstract: The purpose of the present study was to evaluate the prognostic role of C-reactive protein (CRP) in children with Ewing's sarcoma. We conducted a retrospective study on 151 children undergoing multimodal treatment for Ewing's sarcoma in the appendicular ... ...

Abstract	The purpose of the present study was to evaluate the prognostic role of C-reactive protein (CRP) in children with Ewing's sarcoma. We conducted a retrospective study on 151 children undergoing multimodal treatment for Ewing's sarcoma in the appendicular skeleton from December 1997 to June 2020. Univariate Kaplan-Meier analyses of laboratory biomarkers and clinical parameters showed that CRP and metastatic disease at presentation were poor prognostic factors associated with overall survival and disease recurrence at 5 years (
Language	English
Publishing date	2023-03-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15051573
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Article ; Online: Megaprosthetic reconstruction of the distal femur with a short residual proximal femur following bone tumor resection: a systematic review.

Tsukamoto, Shinji / Mavrogenis, Andreas F / Masunaga, Tomoya / Kido, Akira / Honoki, Kanya / Tanaka, Yuu / Fujii, Hiromasa / Tanaka, Yasuhito / Errani, Costantino

Journal of orthopaedic surgery and research

2023 Volume 18, Issue 1, Page(s) 68

Abstract: Background: To investigate the risk of postoperative function and complications associated with reconstruction methods in patients with short residual proximal femurs (< 12 cm) after resection of distal femoral bone tumors, we performed a systematic ... ...

Abstract	Background: To investigate the risk of postoperative function and complications associated with reconstruction methods in patients with short residual proximal femurs (< 12 cm) after resection of distal femoral bone tumors, we performed a systematic review of studies reporting postoperative function and complications in these patients. Methods: Of the 236 studies identified by systematic searches using the Medline, Embase, and Cochrane Central Register of Controlled Trials databases, eight were included (none were randomized controlled trials). In these studies, 106 (68.4%), 12 (7.7%), and 37 (23.9%) patients underwent reconstruction with custom-made megaprostheses with extracortical plates or cross-pins, allograft prosthetic composite (APC), and Compress Results: Aseptic loosening occurred slightly more frequently in the APC group than in the other reconstruction methods (APC group, 21%; custom-made megaprosthesis group, 0-17%; CPS implant group, 14%). No differences were noted in the frequencies of implant breakage, fractures, or infections between the three reconstruction methods. Mechanical survival, where endpoint was set as implant removal for any reason, was 80% at seven years in the APC group, 70-77% at 10 years in the custom-made megaprosthesis group, and 68% at nine years in the CPS implant group. Therefore, there appeared to be no difference among the three reconstruction methods with respect to mechanical survival. Conclusions: During megaprosthetic reconstruction of the distal femur with a short residual proximal femur after bone tumor resection, similar results were obtained using custom-made megaprostheses, APCs, and CPS implants.
MeSH term(s)	Humans ; Prosthesis Design ; Prosthesis Failure ; Treatment Outcome ; Femur/pathology ; Bone Neoplasms/pathology ; Femoral Neoplasms/surgery ; Femoral Neoplasms/pathology ; Arthroplasty, Replacement, Knee/adverse effects ; Retrospective Studies
Language	English
Publishing date	2023-01-27
Publishing country	England
Document type	Systematic Review
ZDB-ID	2252548-8
ISSN	1749-799X ; 1749-799X
ISSN (online)	1749-799X
ISSN	1749-799X
DOI	10.1186/s13018-023-03553-7
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