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John H Healey - One of the best experts on this subject based on the ideXlab platform.
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can we estimate short and intermediate term survival in patients undergoing surgery for metastatic bone disease
Clinical Orthopaedics and Related Research, 2017Co-Authors: Jonathan A Forsberg, Patrick J. Boland, Rikard Wedin, John H HealeyAbstract:Background Objective means of estimating survival can be used to guide surgical decision-making and to risk-stratify patients for clinical trials. Although a free, online tool (www.pathfx.org) can estimate 3- and 12-month survival, recent work, including a survey of the Musculoskeletal Tumor Society, indicated that estimates at 1 and 6 months after surgery also would be helpful. Longer estimates help justify the need for more durable and expensive reconstructive options, and very short estimates could help identify those who will not survive 1 month and should not undergo surgery. Thereby, an important use of this tool would be to help avoid unsuccessful and expensive surgery during the last month of life.
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has the level of evidence of podium presentations at the Musculoskeletal Tumor society annual meeting changed over time
Clinical Orthopaedics and Related Research, 2017Co-Authors: Daniel M Lerman, John H Healey, Matthew Gregory Cable, Patrick Thornley, Nathan Evaniew, Gerard P Slobogean, Mohit Bhandari, R Randall, Michelle GhertAbstract:Level of evidence (LOE) framework is a tool with which to categorize clinical studies based on their likelihood to be influenced by bias. Improvements in LOE have been demonstrated throughout orthopaedics, prompting our evaluation of orthopaedic oncology research LOE to determine if it has changed in kind. (1) Has the LOE presented at the Musculoskeletal Tumor Society (MSTS) annual meeting improved over time? (2) Over the past decade, how do the MSTS and Orthopaedic Trauma Association (OTA) annual meetings compare regarding LOE overall and for the subset of therapeutic studies? We reviewed abstracts from MSTS and OTA annual meeting podium presentations from 2005 to 2014. Three independent reviewers evaluated a total of 1222 abstracts for study type and LOE; there were 577 abstracts from MSTS and 645 from OTA. Changes in the distributions of study type and LOE over time were evaluated by Pearson chi-square test. There was no change over time in MSTS LOE for all study types (p = 0.13) and therapeutic (p = 0.36) study types during the reviewed decade. In contrast, OTA LOE increased over this time for all study types (p < 0.01). The proportion of Level I therapeutic studies was higher at the OTA than the MSTS (3% [14 of 413] versus 0.5% [two of 387], respectively), whereas the proportion of Level IV studies was lower at the OTA than the MSTS (32% [134 of 413] versus 75% [292 of 387], respectively) during the reviewed decade. The proportion of controlled therapeutic studies (LOE I through III) versus uncontrolled studies (LOE IV) increased over time at OTA (p < 0.021), but not at MSTS (p = 0.10). Uncontrolled case series continue to dominate the MSTS scientific program, limiting progress in evidence-based clinical care. Techniques used by the OTA to improve LOE may be emulated by the MSTS. These techniques focus on broad participation in multicenter collaborations that are designed in a comprehensive manner and answer a pragmatic clinical question.
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editorial comment 2014 Musculoskeletal Tumor society
Clinical Orthopaedics and Related Research, 2016Co-Authors: John H HealeyAbstract:A fundamental mission of the Musculoskeletal Tumor Society (MSTS) is to promote the acquisition and sharing of knowledge in the field of orthopaedic oncology. This matches the goal of Clinical Orthopaedics and Related Research and The Association of Bone and Joint Surgeons to disseminate new and important orthopaedic knowledge. CORR, the official Journal of the MSTS since 1997 (and informally for 20 years before that), has effectively met these goals and has been the leading publisher of articles in orthopaedic oncology [4]. Here, I would like to emphasize the ongoing importance of publishing the MSTS Proceedings of the best papers of the preceding annual meeting. The annual meeting of the MSTS continues to be the keystone of intellectual and educational efforts for the Society members. Since its inception, new learned societies have proliferated in this academic space such as the International Society of Limb Salvage (ISOLS), European Musculoskeletal Tumor Society (EMSOS), and the Connective Tissue Oncology Society (CTOS), as well as specialty groups such as the Children’s Oncology Group, and Society of Surgical Oncology. Focused study groups such as the Sacral Study Group have arisen to address specific questions. Collaborations to share data also exist, but I emphasize that the mere sharing of data does not make these collaborations multicenter trials. All of the newer groups and associations, to one degree or another, compete with the MSTS for preeminence. Conjoined meetings with ISOLS (for which CORR is also the official journal), EMSOS, and CTOS have been among the most productive in recent years, enticing the highest quality interaction of participants and publication. MSTS continues to hold an effective independent role in the academic world, in spite of taking on a wide range of educational roles in the American Academy of Orthopaedic Surgeons. MSTS Specialty Day programs have taken on the tenor of instructional courses, informational sessions, subject reviews, and entertaining debates, but rarely present original research work. The scholastic mission of the MSTS mainly is accomplished at the Annual Meeting where our best original research is presented. So how are we doing in this endeavor, and how did it go in 2014? There were 161 abstracts submitted for the 2014 meeting. These resulted in 30 Symposium: 2014 Musculoskeletal Tumor Society Published online: 12 November 2015 The Association of Bone and Joint Surgeons1 2015
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editorial comment 2013 meetings of the Musculoskeletal Tumor society and the international society of limb salvage
Clinical Orthopaedics and Related Research, 2015Co-Authors: John H HealeyAbstract:The author certifies that he, or any members of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research ® editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR ® or the Association of Bone and Joint Surgeons®.
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best targeted sarcoma treatment advances from the Musculoskeletal Tumor society annual meeting
Clinical Orthopaedics and Related Research, 2014Co-Authors: John H HealeyAbstract:Targeted, personalized therapy is the mantra in contemporary oncology. So how does orthopaedic oncology fit into the new paradigm? In the rapidly changing political, legal, and medical landscape, there are challenges and successes for Musculoskeletal cancer patients, practitioners, and researchers as we try to implement individualized therapies. The Musculoskeletal Tumor Society (MSTS) leads, captures, and reflects the societal dynamism that will determine how personalized medicine applies to bone and soft tissue Tumors through the activities of the MSTS members (Fig. 1), their annual meeting, and the selected papers published in this Clinical Orthopaedics and Related Research® symposium.
Hirotaka Kawano - One of the best experts on this subject based on the ideXlab platform.
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reliability and validity of the Musculoskeletal Tumor society scoring system for the upper extremity in japanese patients
Clinical Orthopaedics and Related Research, 2017Co-Authors: Kosuke Uehara, Koichi Ogura, Hirotaka Kawano, Toru Akiyama, Yusuke Shinoda, Shintaro Iwata, Eisuke Kobayashi, Yoshikazu Tanzawa, Tsukasa Yonemoto, Akira KawaiAbstract:Background The Musculoskeletal Tumor Society (MSTS) scoring system developed in 1993 is a widely used disease-specific evaluation tool for assessment of physical function in patients with Musculoskeletal Tumors; however, only a few studies have confirmed its reliability and validity.
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reliability and validity of the Musculoskeletal Tumor society scoring system for the upper extremity in japanese patients
Clinical Orthopaedics and Related Research, 2017Co-Authors: Kosuke Uehara, Koichi Ogura, Hirotaka Kawano, Toru Akiyama, Yusuke Shinoda, Shintaro Iwata, Eisuke Kobayashi, Yoshikazu Tanzawa, Tsukasa Yonemoto, Akira KawaiAbstract:The Musculoskeletal Tumor Society (MSTS) scoring system developed in 1993 is a widely used disease-specific evaluation tool for assessment of physical function in patients with Musculoskeletal Tumors; however, only a few studies have confirmed its reliability and validity. The aim of this study was to validate the MSTS scoring system for the upper extremity (MSTS-UE) in Japanese patients with Musculoskeletal Tumors for use by others in research. Does the MSTS-UE have: (1) sufficient reliability and internal consistency; (2) adequate construct validity; and (3) reasonable criterion validity in comparison to the Toronto Extremity Salvage Score (TESS) or SF-36? Reliability was performed using test-retest analysis, and internal consistency was evaluated with Cronbach’s alpha coefficient. Construct validity was evaluated using a scree plot to confirm the construct number and the Akaike information criterion network. Criterion validity was evaluated by comparing the MSTS-UE with the TESS and SF-36. The test-retest reliability with intraclass correlation coefficient (0.95; 95% CI, 0.91–0.97) was excellent, and internal consistency with Cronbach’s α (0.7; 95% CI, 0.53–0.81) was acceptable. There were no ceiling and floor effects. The Akaike Information Criterion network showed that lifting ability, pain, and dexterity played central roles among the components. The MSTS-UE showed substantial correlation with the TESS scoring scale (r = 0.75; p < 0.001) and fair correlation with the SF-36 physical component summary (r = 0.37; p = 0.007). Although the MSTS-UE showed slight correlation with the SF-36 mental component summary, the emotional acceptance component of the MSTS-UE showed fair correlation (r = 0.29; p = 0.039). We can conclude that the MSTS is not an adequate measure of general health-related quality of life; however, this system was designed mainly to be a simple measure of function in a single extremity. To evaluate the mental state of patients with Musculoskeletal Tumors in the upper extremity, further study is needed.
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what is the effect of advanced age and comorbidity on postoperative morbidity and mortality after Musculoskeletal Tumor surgery
Clinical Orthopaedics and Related Research, 2014Co-Authors: Koichi Ogura, Hideo Yasunaga, Hiromasa Horiguchi, Kiyohide Fushimi, Hirotaka KawanoAbstract:Background Although the elderly population is increasing rapidly, little information is available regarding how the risk of postoperative mortality and morbidity increases when combined with age and comorbidity burden in patients undergoing Musculoskeletal Tumor surgery.
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nomogram predicting severe adverse events after Musculoskeletal Tumor surgery analysis of a national administrative database
Annals of Surgical Oncology, 2014Co-Authors: Koichi Ogura, Hideo Yasunaga, Hiromasa Horiguchi, Kiyohide Fushimi, Sakae Tanaka, Hirotaka KawanoAbstract:There have been no nationwide surveys of postoperative adverse events (AEs) after Musculoskeletal Tumor surgery focusing on their severity. Therefore, we developed a nomogram to predict severe AEs after Musculoskeletal Tumor surgery. We identified patients in the Diagnosis Procedure Combination database who underwent Musculoskeletal Tumor surgery during 2007–2012, and defined severe AEs as follows: (i) in-hospital mortality; (ii) postoperative medications including massive transfusion (≥1,400 mL), catecholamines, γ-globulin products, protease inhibitors, and medications for disseminated intravascular coagulation; and (iii) postoperative interventions consisting of mechanical ventilation, dialysis support, and cardiac support. Logistic regression models were used to address the occurrence of severe AEs. Of 5,716 patients identified, 613 patients (10.7 %) had severe AEs. Multivariate analyses showed an inverse relationship between body mass index (BMI) and severe AEs (odds ratio 1.80 for BMI <18.50; p < 0.001) after adjustment for other significant factors, including sex, age, Tumor location, Charlson comorbidity index, type of surgery, and duration of anesthesia. A nomogram and a calibration plot based on these results were well-fitted to predict the probability of severe AEs after Musculoskeletal Tumor surgery (concordance index 0.781). We developed a nomogram predicting the probability of severe AEs after Musculoskeletal Tumor surgery. In addition, we clarified that underweight, but not overweight or obese, status was significantly associated with increased severe AEs after adjusting for patient background characteristics.
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impact of hospital volume on postoperative complications and in hospital mortality after Musculoskeletal Tumor surgery analysis of a national administrative database
Journal of Bone and Joint Surgery American Volume, 2013Co-Authors: Koichi Ogura, Hideo Yasunaga, Hiromasa Horiguchi, Sakae Tanaka, Yusuke Shinoda, Kazuhiko Ohe, Hirotaka KawanoAbstract:Background: We are aware of only one report describing the relationship between operative volume and outcomes in Musculoskeletal Tumor surgery, although numerous studies have described such relationships in other surgical procedures. The aim of the present study was to use a nationally representative inpatient database to evaluate the impact of hospital volume on the rates of postoperative complications and in-hospital mortality after Musculoskeletal Tumor surgery. Methods: We used the Japanese Diagnostic Procedure Combination administrative database to retrospectively identify 4803 patients who had undergone Musculoskeletal Tumor surgery during 2007 to 2010. Patients were then divided into tertiles of approximately equal size on the basis of the annual hospital volume (number of patients undergoing Musculoskeletal Tumor surgery): low, twelve or fewer cases/year; medium, thirteen to thirty-one cases/year; and high, thirty-two or more cases/year. Logistic regression analyses were performed to examine the relationships between various factors and the rates of postoperative complications and in-hospital mortality adjusted for all patient demographic characteristics. Results: The overall postoperative complication rate was 7.2% (348 of 4803), and the in-hospital mortality rate was 2.4% (116 of 4803). Postoperative complications included surgical site infections in 132 patients (2.7%), cardiac events in sixty-four (1.3%), respiratory complications in fifty-one (1.1%), sepsis in thirty-one (0.6%), pulmonary emboli in sixteen (0.3%), acute renal failure in eleven (0.2%), and cerebrovascular events in seven (0.1%). The postoperative complication rate was related to the duration of anesthesia (odds ratio [OR] for a duration of more than 240 compared with less than 120 minutes, 2.44; 95% confidence interval [CI], 1.68 to 3.53; p < 0.001) and to hospital volume (OR for high compared with low volume, 0.73; 95% CI, 0.55 to 0.96; p = 0.027). The mortality rate was related to the diagnosis (OR for a metastatic compared with a primary bone Tumor, 3.67; 95% CI, 1.66 to 8.09; p = 0.001), type of surgery (OR for amputation compared with soft-tissue Tumor resection without prosthetic reconstruction, 3.81; 95% CI, 1.42 to 10.20; p = 0.008), and hospital volume (OR for high compared with low volume, 0.26; 95% CI, 0.14 to 0.50; p < 0.001). Conclusions: We identified an independent effect of hospital volume on outcomes after adjusting for patient demographic characteristics. We recommend regionalization of Musculoskeletal Tumor surgery to high-volume hospitals in an attempt to improve patient outcomes. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Koichi Ogura - One of the best experts on this subject based on the ideXlab platform.
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reliability and validity of the Musculoskeletal Tumor society scoring system for the upper extremity in japanese patients
Clinical Orthopaedics and Related Research, 2017Co-Authors: Kosuke Uehara, Koichi Ogura, Hirotaka Kawano, Toru Akiyama, Yusuke Shinoda, Shintaro Iwata, Eisuke Kobayashi, Yoshikazu Tanzawa, Tsukasa Yonemoto, Akira KawaiAbstract:Background The Musculoskeletal Tumor Society (MSTS) scoring system developed in 1993 is a widely used disease-specific evaluation tool for assessment of physical function in patients with Musculoskeletal Tumors; however, only a few studies have confirmed its reliability and validity.
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reliability and validity of the Musculoskeletal Tumor society scoring system for the upper extremity in japanese patients
Clinical Orthopaedics and Related Research, 2017Co-Authors: Kosuke Uehara, Koichi Ogura, Hirotaka Kawano, Toru Akiyama, Yusuke Shinoda, Shintaro Iwata, Eisuke Kobayashi, Yoshikazu Tanzawa, Tsukasa Yonemoto, Akira KawaiAbstract:The Musculoskeletal Tumor Society (MSTS) scoring system developed in 1993 is a widely used disease-specific evaluation tool for assessment of physical function in patients with Musculoskeletal Tumors; however, only a few studies have confirmed its reliability and validity. The aim of this study was to validate the MSTS scoring system for the upper extremity (MSTS-UE) in Japanese patients with Musculoskeletal Tumors for use by others in research. Does the MSTS-UE have: (1) sufficient reliability and internal consistency; (2) adequate construct validity; and (3) reasonable criterion validity in comparison to the Toronto Extremity Salvage Score (TESS) or SF-36? Reliability was performed using test-retest analysis, and internal consistency was evaluated with Cronbach’s alpha coefficient. Construct validity was evaluated using a scree plot to confirm the construct number and the Akaike information criterion network. Criterion validity was evaluated by comparing the MSTS-UE with the TESS and SF-36. The test-retest reliability with intraclass correlation coefficient (0.95; 95% CI, 0.91–0.97) was excellent, and internal consistency with Cronbach’s α (0.7; 95% CI, 0.53–0.81) was acceptable. There were no ceiling and floor effects. The Akaike Information Criterion network showed that lifting ability, pain, and dexterity played central roles among the components. The MSTS-UE showed substantial correlation with the TESS scoring scale (r = 0.75; p < 0.001) and fair correlation with the SF-36 physical component summary (r = 0.37; p = 0.007). Although the MSTS-UE showed slight correlation with the SF-36 mental component summary, the emotional acceptance component of the MSTS-UE showed fair correlation (r = 0.29; p = 0.039). We can conclude that the MSTS is not an adequate measure of general health-related quality of life; however, this system was designed mainly to be a simple measure of function in a single extremity. To evaluate the mental state of patients with Musculoskeletal Tumors in the upper extremity, further study is needed.
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reliability and validity of a japanese language and culturally adapted version of the Musculoskeletal Tumor society scoring system for the lower extremity
Clinical Orthopaedics and Related Research, 2016Co-Authors: Shintaro Iwata, Koichi Ogura, Kosuke Uehara, Toru Akiyama, Yusuke Shinoda, Tsukasa Yonemoto, Akira KawaiAbstract:Background The Musculoskeletal Tumor Society (MSTS) scoring system is a widely used functional evaluation tool for patients treated for Musculoskeletal Tumors. Although the MSTS scoring system has been validated in English and Brazilian Portuguese, a Japanese version of the MSTS scoring system has not yet been validated.
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what is the effect of advanced age and comorbidity on postoperative morbidity and mortality after Musculoskeletal Tumor surgery
Clinical Orthopaedics and Related Research, 2014Co-Authors: Koichi Ogura, Hideo Yasunaga, Hiromasa Horiguchi, Kiyohide Fushimi, Hirotaka KawanoAbstract:Background Although the elderly population is increasing rapidly, little information is available regarding how the risk of postoperative mortality and morbidity increases when combined with age and comorbidity burden in patients undergoing Musculoskeletal Tumor surgery.
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nomogram predicting severe adverse events after Musculoskeletal Tumor surgery analysis of a national administrative database
Annals of Surgical Oncology, 2014Co-Authors: Koichi Ogura, Hideo Yasunaga, Hiromasa Horiguchi, Kiyohide Fushimi, Sakae Tanaka, Hirotaka KawanoAbstract:There have been no nationwide surveys of postoperative adverse events (AEs) after Musculoskeletal Tumor surgery focusing on their severity. Therefore, we developed a nomogram to predict severe AEs after Musculoskeletal Tumor surgery. We identified patients in the Diagnosis Procedure Combination database who underwent Musculoskeletal Tumor surgery during 2007–2012, and defined severe AEs as follows: (i) in-hospital mortality; (ii) postoperative medications including massive transfusion (≥1,400 mL), catecholamines, γ-globulin products, protease inhibitors, and medications for disseminated intravascular coagulation; and (iii) postoperative interventions consisting of mechanical ventilation, dialysis support, and cardiac support. Logistic regression models were used to address the occurrence of severe AEs. Of 5,716 patients identified, 613 patients (10.7 %) had severe AEs. Multivariate analyses showed an inverse relationship between body mass index (BMI) and severe AEs (odds ratio 1.80 for BMI <18.50; p < 0.001) after adjustment for other significant factors, including sex, age, Tumor location, Charlson comorbidity index, type of surgery, and duration of anesthesia. A nomogram and a calibration plot based on these results were well-fitted to predict the probability of severe AEs after Musculoskeletal Tumor surgery (concordance index 0.781). We developed a nomogram predicting the probability of severe AEs after Musculoskeletal Tumor surgery. In addition, we clarified that underweight, but not overweight or obese, status was significantly associated with increased severe AEs after adjusting for patient background characteristics.
Akira Kawai - One of the best experts on this subject based on the ideXlab platform.
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experience of total scapular excision for Musculoskeletal Tumor and reconstruction in eastern asian countries
Journal of bone oncology, 2017Co-Authors: Katsuhiro Hayashi, Akira Kawai, Akihiko Takeuchi, Norio Yamamoto, Toshiharu Shirai, Xiaohui Niu, Xiaodong Tang, Vivek Ajit Singh, Apichat Asavamongkolkul, Hiroaki KimuraAbstract:Abstract Total scapulectomy and reconstruction has been performed for scapular Tumor, however, most of the reconstruction methods have resulted in poor functional outcomes and there is still room for improvement. Most of the reports of reconstruction after scapulectomy are from a single institution. In the present study, we investigated functional outcomes after total scapulectomy in a multicenter study in The Eastern Asian Musculoskeletal Oncology Group (EAMOG). Thirty-three patients who underwent total scapulectomy were registered at EAMOG affiliated hospitals. The patients were separated into no reconstruction group (n=8), humeral suspension group (n=15) and prosthesis group (n=10). Functional outcome was assessed by the Enneking score. One-way ANOVA was used to compare parameters between the patient groups. Complications included five local recurrences, one superficial infection, one dislocation and one clavicle protrusion. The average follow-up period was 43.5 months. The average active flexion range was 45.8° (0–120°), and 37.1° in abduction (0–120°). The mean total functional score was 22.9 out of 30 (15–29), which is a satisfactory score following resection of the shoulder girdle. There were significant differences in reconstruction methods for active range of motion. Bony reconstruction provided better range of motion in this study. There was a variety of reconstruction methods after scapulectomy in the eastern Asian countries. Although better functional score was obtained using scapular prosthesis or recycled bone and prosthesis composite grafting, postoperative function is still lower than preoperative function. Modified designed prosthesis with or without combination of recycle bone or allograft would restore the lost shoulder function in the future.
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reliability and validity of the Musculoskeletal Tumor society scoring system for the upper extremity in japanese patients
Clinical Orthopaedics and Related Research, 2017Co-Authors: Kosuke Uehara, Koichi Ogura, Hirotaka Kawano, Toru Akiyama, Yusuke Shinoda, Shintaro Iwata, Eisuke Kobayashi, Yoshikazu Tanzawa, Tsukasa Yonemoto, Akira KawaiAbstract:Background The Musculoskeletal Tumor Society (MSTS) scoring system developed in 1993 is a widely used disease-specific evaluation tool for assessment of physical function in patients with Musculoskeletal Tumors; however, only a few studies have confirmed its reliability and validity.
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reliability and validity of the Musculoskeletal Tumor society scoring system for the upper extremity in japanese patients
Clinical Orthopaedics and Related Research, 2017Co-Authors: Kosuke Uehara, Koichi Ogura, Hirotaka Kawano, Toru Akiyama, Yusuke Shinoda, Shintaro Iwata, Eisuke Kobayashi, Yoshikazu Tanzawa, Tsukasa Yonemoto, Akira KawaiAbstract:The Musculoskeletal Tumor Society (MSTS) scoring system developed in 1993 is a widely used disease-specific evaluation tool for assessment of physical function in patients with Musculoskeletal Tumors; however, only a few studies have confirmed its reliability and validity. The aim of this study was to validate the MSTS scoring system for the upper extremity (MSTS-UE) in Japanese patients with Musculoskeletal Tumors for use by others in research. Does the MSTS-UE have: (1) sufficient reliability and internal consistency; (2) adequate construct validity; and (3) reasonable criterion validity in comparison to the Toronto Extremity Salvage Score (TESS) or SF-36? Reliability was performed using test-retest analysis, and internal consistency was evaluated with Cronbach’s alpha coefficient. Construct validity was evaluated using a scree plot to confirm the construct number and the Akaike information criterion network. Criterion validity was evaluated by comparing the MSTS-UE with the TESS and SF-36. The test-retest reliability with intraclass correlation coefficient (0.95; 95% CI, 0.91–0.97) was excellent, and internal consistency with Cronbach’s α (0.7; 95% CI, 0.53–0.81) was acceptable. There were no ceiling and floor effects. The Akaike Information Criterion network showed that lifting ability, pain, and dexterity played central roles among the components. The MSTS-UE showed substantial correlation with the TESS scoring scale (r = 0.75; p < 0.001) and fair correlation with the SF-36 physical component summary (r = 0.37; p = 0.007). Although the MSTS-UE showed slight correlation with the SF-36 mental component summary, the emotional acceptance component of the MSTS-UE showed fair correlation (r = 0.29; p = 0.039). We can conclude that the MSTS is not an adequate measure of general health-related quality of life; however, this system was designed mainly to be a simple measure of function in a single extremity. To evaluate the mental state of patients with Musculoskeletal Tumors in the upper extremity, further study is needed.
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reliability and validity of a japanese language and culturally adapted version of the Musculoskeletal Tumor society scoring system for the lower extremity
Clinical Orthopaedics and Related Research, 2016Co-Authors: Shintaro Iwata, Koichi Ogura, Kosuke Uehara, Toru Akiyama, Yusuke Shinoda, Tsukasa Yonemoto, Akira KawaiAbstract:Background The Musculoskeletal Tumor Society (MSTS) scoring system is a widely used functional evaluation tool for patients treated for Musculoskeletal Tumors. Although the MSTS scoring system has been validated in English and Brazilian Portuguese, a Japanese version of the MSTS scoring system has not yet been validated.
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primary de novo dedifferentiated liposarcoma in the extremities a multi institution tohoku Musculoskeletal Tumor society study of 18 cases in northern japan
Japanese Journal of Clinical Oncology, 2011Co-Authors: Kyoji Okada, Takahiro Tajino, Akira Ogose, Akira Kawai, Tadashi Hasegawa, Jun Nishida, Michiro Yanagisawa, Tetsuro Morita, Takashi TsuchiyaAbstract:OBJECTIVE: Dedifferentiated liposarcomas usually occur in the retroperitoneal space and relatively rarely in the extremities. METHODS: We identified 18 patients with primary dedifferentiated liposarcoma in the extremities from the files of Tohoku Musculoskeletal Tumor Society and analyzed demographics, histologic findings, treatments and prognostic factors. The average follow-up period was 58 months. RESULTS: The subjects were 12 men and 6 women with a mean age of 65 years. All Tumors were in the thigh. Nine patients noticed a rapid enlargement of the long-standing Tumor. Histologic subtypes of the dedifferentiated area were undifferentiated pleomorphic sarcoma (n = 12), osteosarcoma (n = 2), rhabdomyosarcoma (n = 2), leiomyosarcoma (n = 1) and malignant peripheral nerve sheath Tumor (n = 1). In the patient with rhabdomyosarcoma-like dedifferentiated area, extensive necrosis was observed after the preoperative chemotherapy. One patient who underwent marginal excision developed a local recurrence, but inadequate surgical margin was not associated with a risk of local recurrence. Three patients had lung metastasis at initial presentation, and four other patients developed lung metastases during the follow-up period. The overall survival rate was 61.1% at 5 years. On univariate analyses, large size of the dedifferentiated area (>8 cm), high MIB-1-labeling index (>30%) for the dedifferentiated area and lung metastasis at initial presentation were significantly associated with poor prognosis. CONCLUSIONS: Primary dedifferentiated liposarcoma in the extremities predominantly occurred in the thigh and a rapid enlargement of long-standing Tumors was a characteristic symptom. Although the local behavior of these Tumors was less aggressive than that of retroperitoneal dedifferentiated liposarcomas, they had a relatively high metastatic potential.
Brooke Crawford - One of the best experts on this subject based on the ideXlab platform.
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surveillance strategies for sarcoma results of a survey of members of the Musculoskeletal Tumor society
Sarcoma, 2016Co-Authors: David D Greenberg, Brooke CrawfordAbstract:Background. Surveillance is crucial to oncology, yet there is scant evidence to guide strategies. Purpose. This survey identified sarcoma surveillance strategies for Musculoskeletal Tumor Society (MSTS) members and rationales behind them. Understanding current practice should facilitate studies to generate evidence-based surveillance protocols. Methods. Permission was granted by the Research and Executive Committee of the MSTS to survey members on surveillance strategies. First, the questionnaire requested demographic and clinical practice information. Second, the survey focused on clinicians’ specific surveillance soft tissue and bone sarcoma protocols. Results. 20 percent of MSTS members completed the survey. The primary rationale for protocols was training continuation, followed by published guidelines, and finally personal interpretation of the literature. 95% of the respondents believe that additional studies regarding appropriate surveillance protocols are needed. 87% reported patient concerns regarding radiation exposure from surveillance imaging. For soft tissue and bone sarcoma local recurrence, responders identified surgical margin, histologic grade, and Tumor size as the most important factors. For metastases, important risk factors identified included histologic grade, Tumor size, and histologic type. Protocols demonstrated wide variation. Conclusion. This survey demonstrates that surveillance strategies utilized by MSTS members are not evidence-based, providing rationale for multi-institutional studies. It also confirms the public health issue of excessive radiation exposure.
