This Update provides a review of work published in the area of primary musculoskeletal tumors between May 2015 and June 2016. The studies are largely Level III and IV, in part due to the rarity and varied nature of such tumors. The articles were identified by searching PubMed and reviewing prominent journals.
Margins and local recurrence were the focus of several osteosarcoma studies. Bertrand et al. reviewed 51 high-grade extremity sarcomas with localized disease at presentation and found that a positive margin compared with a negative margin of >1 mm was the only factor that independently predicted local recurrence1. They confirmed that patients with a positive surgical margin had an increased risk of death from disease compared with those with negative margins. In another study, no local recurrences were noted among 11 patients followed for a minimum of 37 months who had undergone joint-sparing surgery for proximal tibial osteosarcoma that invaded the physis2. The proximal edge of the tumors was treated with intraoperative microwave ablation prior to tumor resection. The proximal osteotomies were planned at the edge of the tumor, but there were no positive margins.
As Ewing sarcoma survival has improved, the factors influencing long-term outcomes have become more important. Stish et al. analyzed scores of the Toronto Extremity Salvage Score (TESS) and Pediatric Quality of Life Inventory (PedsQL) for 74 patients at an average duration of follow-up of 17.8 years3. They found that TESS results were better for those diagnosed at <18 years of age and that PedsQL scores were better for male patients than for female patients. Pelvic tumors were associated with decreased functional outcomes but not lower quality-of-life scores compared with tumors from other sites. The authors were not able to measure an effect of local therapy modality.
Survival among …
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