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Bone Cancer: Diagnoses, Treatments and Challenges
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Bone Cancer: Diagnoses, Treatments and Challenges

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (10 October 2023) | Viewed by 5438

Special Issue Editors

Dr. Liang Chen

E-Mail Website
Guest Editor
School of Medicine, Chongqing University, Chongqing, China
Interests: exosomes; metastatic spinal tumors; spinal trauma; intervertebral disc disease; degenerative spinal diseases
Special Issues, Collections and Topics in MDPI journals
Dr. Yuxi Su

E-Mail Website
Guest Editor
Department of Orthopedics, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
Interests: osteosarcoma; mesenchymal stem cells; cell differentiation

Special Issue Information

Dear Colleagues,

Bone involvement with tumors frequently occurs, and is the third most common site for tumor metastasis. Unusual cells grow out of control in patients’ bones and destroy normal bone tissue. Considering the great negative effects on the quality of life of affected patients, clinicians have been working on novel treatments. Additionally, with the development of minimally invasive surgical techniques, clinicians have attempted to utilize these for the treatment of bone tumors. Nevertheless, clinicians have had to face challenges in deciding which treatment method is the most suitable and effective for each patient.

This Special Issue, "Bone Tumor: Diagnoses, Treatments and Challenges", aims to collect original contributions focusing on the diagnosis and treatment of metastatic spinal tumors, spinal trauma, intervertebral disc diseases and degenerative spinal diseases using, for example, minimally invasive spinal surgery. We hope that our work improves or sheds light on treatments of bone tumor diseases and provides better treatment for patients.

Dr. Liang Chen
Dr. Yuxi Su
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bone tumor
  • spinal surgery
  • metastatic spinal tumor
  • spinal trauma
  • minimally invasive surgery

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Published Papers (4 papers)

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11 pages, 1685 KiB  
Article
High Risk for Persistent Peri-Prosthetic Infection and Amputation in Mega-Prosthesis Reconstruction
by Christina Berger, Catharina Parai, Jonatan Tillander, Peter Bergh, David Wennergren and Helena Brisby
J. Clin. Med. 2023, 12(10), 3575; https://doi.org/10.3390/jcm12103575 - 20 May 2023
Cited by 2 | Viewed by 1182
Abstract
A peri-prosthetic joint infection is a feared complication after mega-prosthesis reconstruction of large bone defects. The current study investigates how patients operated with a mega-prosthesis due to sarcoma, metastasis, or trauma, are affected by a deep infection focusing on re-operations, risk for persistent [...] Read more.
A peri-prosthetic joint infection is a feared complication after mega-prosthesis reconstruction of large bone defects. The current study investigates how patients operated with a mega-prosthesis due to sarcoma, metastasis, or trauma, are affected by a deep infection focusing on re-operations, risk for persistent infection, arthrodesis, or subsequent amputation. Time to infection, causative bacterial strains, mode of treatment and length of hospital stay are also reported. A total of 114 patients with 116 prostheses were evaluated, a median of 7.6 years (range 3.8–13.7) after surgery, of which 35 (30%) were re-operated due to a peri-prosthetic infection. Of the infected patients, the prosthesis was still in place in 51%, 37% were amputated, and 9% had an arthrodesis. The infection was persistent in 26% of the infected patients at follow-up. The mean total length of hospital stay was 68 (median 60) days and the mean number of reoperations was 8.9 (median 6.0). The mean length of antibiotic treatment was 340 days (median 183). Coagulase-negative staphylococci and Staphylococcus aureus were the most frequent bacterial agents isolated in deep cultures. No MRSA- or ESBL-producing Enterobacterales were found but vancomycin-resistant Enterococcus faecium was isolated in one patient. In summary, there is a high risk for peri-prosthetic infection in mega-prostheses, resulting in persistent infection or amputation relatively often. Full article
(This article belongs to the Special Issue Bone Cancer: Diagnoses, Treatments and Challenges)
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12 pages, 3348 KiB  
Article
Full Endoscopy Combined with Allogeneic Bone Grafting for Benign Spinal Lesions: Technical Notes and Preliminary Clinical Results
by Cong-Gang Liao, Wen-Ge He, Qi-Chang Li, Qiang Ren, Jia-Nan Zhang, Liang-Jie He, Xiao-Juan Zhang and Liang Chen
J. Clin. Med. 2023, 12(8), 2990; https://doi.org/10.3390/jcm12082990 - 20 Apr 2023
Viewed by 1262
Abstract
Benign lesions of the spine include benign tumors and tumor-like lesions of the spine, which usually occur in the thoracic and lumbar vertebrae. The incidence rate is low, accounting for about 1% of primary bone tumors. Few cases of endoscopic treatment of benign [...] Read more.
Benign lesions of the spine include benign tumors and tumor-like lesions of the spine, which usually occur in the thoracic and lumbar vertebrae. The incidence rate is low, accounting for about 1% of primary bone tumors. Few cases of endoscopic treatment of benign spinal lesions have been reported in the literature. Here, we introduce a new surgical technique using full endoscopy and allogeneic bone grafting to treat benign spinal lesions. All patients in this study successfully underwent the operation, and their pain was significantly relieved postoperatively. The patient VAS scores decreased from 3.07 ± 0.70 preoperatively to 0.33 ± 0.49 at the last follow-up visit (p < 0.05). The mean total blood loss (including drainage blood) was 16.67 ± 6.98 mL. The mean operative time was 63.33 ± 7.23 min. No patients developed numbness in the corresponding segmental distribution after surgery, none of the patients had serious postoperative complications, and none had focal recurrence during follow-up requiring reoperation. Patients reported symptom relief throughout the whole follow-up period. We believe that endoscopic surgery preserves the ligaments and soft tissues around the vertebral body, and that this technique is feasible with minimal trauma, rapid recovery, and good outcomes at short-term follow-up. This minimally invasive treatment modality offers a new option for the treatment of patients with benign spinal lesions. Full article
(This article belongs to the Special Issue Bone Cancer: Diagnoses, Treatments and Challenges)
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23 pages, 2889 KiB  
Systematic Review
A Systematic Review and Illustrative Case Presentation of Low-Grade Myofibroblastic Sarcoma (LGMS) of the Extremities
by Astrid Schenker, Ewgenija Gutjahr, Burkhard Lehner, Gunhild Mechtersheimer, Eva Wardelmann, Rosa Klotz, Eva Kalkum, Marcus Schiltenwolf, Leila Harhaus, Tobias Renkawitz and Benjamin Panzram
J. Clin. Med. 2023, 12(22), 7027; https://doi.org/10.3390/jcm12227027 - 10 Nov 2023
Viewed by 1106
Abstract
Introduction: Low-grade myofibroblastic sarcoma (LGMS) is a rare tumor entity which occurs in the subcutaneous and deep soft tissues; it is less common in the bone with a predilection for the extremities and the head and neck region. As confirming the diagnosis is [...] Read more.
Introduction: Low-grade myofibroblastic sarcoma (LGMS) is a rare tumor entity which occurs in the subcutaneous and deep soft tissues; it is less common in the bone with a predilection for the extremities and the head and neck region. As confirming the diagnosis is difficult and treatment strategies are not standardized, we aimed to identify patient and tumor characteristics, and to summarize treatment strategies and their clinical outcomes to guide surgeons. Methods: Included were full articles reporting patients with histology of LGMS in the extremities, excluding tumors of the trunk. All patients underwent surgery but with different extend, from marginal to wide resection. Included studies should inform about local recurrence, metastasis, or evidence of disease, depending on the surgical treatment. We conducted a structured search using MEDLINE (via PubMed), Web of Science, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) to identify studies on low-grade myofibroblastic sarcoma of the extremities. Study designs like randomized controlled trials, systematic reviews, prospective trials, retrospective studies, and case reports were included. Prospective studies and comparative studies were not available at all. Therefore, meta-analysis was not possible and statistical analysis was purely descriptive. Results: Of the 789 studies identified from our initial search, 17 studies including 59 cases reported LGMS of the extremities with the surgical treatment and clinical outcome and were therefore analyzed. In addition, we present the rare case and surgical management of a 28-year-old male patient with residual LGMS of the thumb after an initial incomplete resection. The current literature suggests that a wide excision with R0 margins should be considered the standard treatment for LGMS. In cases where surgery leads to significant functional impairment, individual options like free tissue transfer from a donor site have to be considered. Therefore, we also present an illustrative case. For all selected case series and case reports, a high risk of confounding, selection bias, information bias, and reporting bias must be anticipated. Nevertheless, this systematic review provides a comprehensive overview on surgical treatment and clinical outcomes in LGMS surgery of the extremities. Full article
(This article belongs to the Special Issue Bone Cancer: Diagnoses, Treatments and Challenges)
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10 pages, 702 KiB  
Systematic Review
Electrochemotherapy in the Treatment of Bone Metastases: A Systematic Review
by Maria Beatrice Bocchi, Cesare Meschini, Silvia Pietramala, Andrea Perna, Maria Serena Oliva, Maria Rosaria Matrangolo, Antonio Ziranu, Giulio Maccauro and Raffaele Vitiello
J. Clin. Med. 2023, 12(19), 6150; https://doi.org/10.3390/jcm12196150 - 23 Sep 2023
Cited by 3 | Viewed by 1027
Abstract
Background and aim: Cancers are one of the most frequent causes of death and disability in humans. Skeletal involvement has a major impact on the quality of life and prognosis of cancer patients. Electrochemotherapy is a palliative and minimally invasive oncologic treatment that [...] Read more.
Background and aim: Cancers are one of the most frequent causes of death and disability in humans. Skeletal involvement has a major impact on the quality of life and prognosis of cancer patients. Electrochemotherapy is a palliative and minimally invasive oncologic treatment that was first used to treat subcutaneous nodules for malignant tumors. The aim of our review is to evaluate the results of electrochemotherapy in the treatment of bone metastases. Methods: A systematic review of the literature indexed in the PubMed MEDLINE and Cochrane Library databases using the search key words “electrochemotherapy” AND (“metastasis” OR “metastases”) was performed. The Preferred Reporting Items for Systematic Reviews and MetaAnalyses was followed. Inclusion criteria were proven involvement of the appendicular skeleton in metastatic carcinoma or melanoma, through at least one percutaneous electrochemotherapy session on the metastatic bone lesion. The exclusion criterion was no skeletal metastatic involvement. Results: Eight articles were finally included. We reached a population of 246 patients. The mean age and follow up were 60.1 years old and 11.4 months, respectively. The most represented primary tumor was breast cancer (18.9%). A total of 250 bone lesions were treated with electrochemotherapy. According to RECIST criteria, in our population we observed 55.5% stable diseases. The mean pre-electrochemotherapy VAS value was 6.9, which lowered to 2.7 after treatment. Adverse events occurred in 3.4% of patients. Conclusions: Electrochemotherapy as a minimally invasive and tissue-sparing treatment should be considered for patients with no other alternative to obtain tumor control and improvement in quality of life. Full article
(This article belongs to the Special Issue Bone Cancer: Diagnoses, Treatments and Challenges)
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