OBJECTIVETo evaluate the survival rates and complications of combined therapy for primary osteosarcoma of the extremities between 1992 and 2001.

METHODSFrom 1992 to 2002, 189 patients with non-metastatic osteosarcoma were treated. Their average age at diagnosis was 18 years old (ranging from 4 to 39). Tumors were located at distal femurs in 86 patients, proximal femurs in 4, proximal tibia in 52, proximal humors in 19 and other locations in 28. Combined therapy (resection of tumor with chemotherapy) was given 116 patients and non-combined therapy (tumor resection only and unfinished chemotherapy) to 73. In combined therapy group, 90 patients underwent limb salvage surgery, and 26 patients received amputations. In non-combined therapy group, 42 patients underwent limb salvage surgery and 31 patients received amputations.

RESULTSThe 5-year-survival rates were 78.5% in the combined therapy group and 35.1% in the non-combined therapy group. Local recurrence rate was 16.6% (15 cases) in limb salvage surgery with combined therapy group (90 cases) and 38.1% (16 cases) in limb salvage surgery with non-combined therapy group (42 cases) (P < 0.007). Metastasis rate was 28.4% (33 cases) in the combined therapy group (116 cases) and 65.7% (48 cases) in the non-combined therapy group (73 cases) (P < 0.000). Functional evaluation showed that the patients who underwent salvage surgery had higher functional scores than those who had an amputation. According to MSTS scoring system (1993), 56 patients (excision alcohol replacement 36 cases, allograft 10 cases and prosthesis 10 cases) were evaluated functional scores. The average scores reached same level (P > 0.5).

CONCLUSIONS(1) In this study, the 5-year-survival rate in the combined therapy is improved. The treatment for the patients with metastasis in lung is very difficult for improvement of the 5-year-survival rate. (2) The local recurrence is related the surgical margin. The adequate surgical margin is very important for the limb salvage. (3) The combined therapy is very essential for improving survival rate.

Adolescent ; Adult ; Amputation ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; mortality ; pathology ; therapy ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Limb Salvage ; Male ; Osteosarcoma ; mortality ; pathology ; therapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome

PURPOSE: To evaluate the prognosis of nasopharyngeal carcinoma (NPC) patients who developed bone-only metastasis after primary treatment and the stratification of these patients into different risk groups based on independent prognostic factors. MATERIALS AND METHODS: Eighty NPC patients who developed bone-only metastasis after definitive radiotherapy from October 2005 to December 2010 were enrolled. All these patients received palliative treatment for bone metastasis, including chemotherapy and/or radiotherapy. Clinical features, treatment modality, and laboratory parameters were examined with univariate and multivariate analyses. RESULTS: The median follow-up time was 15.5 months (range, 2-67 months) for the whole cohort. The median overall metastatic survival (OMS) time and the 2-year estimate OMS rate were 26.5 months and 52%, respectively. Multivariate analysis indicated that patients with short metastases-free interval, multiple bone metastases sites, high serum lactic dehydrogenase levels, and treated with radiotherapy or chemotherapy alone had significantly worse outcomes. Patients were stratified into three different risk groups based on the number of adverse factors present. The OMS curves of the three groups were all significantly different (p<0.001). CONCLUSION: Severl prognostic factors were found to be associated with worse outcomes. According to the number of adverse factors present, bone-only metastasis patients can be stratified into three risk groups with significantly different prognoses. Such grouping may help in improving the design of clinical trials and in guiding individualized treatment for NPC patients with bone-only metastasis.
Adolescent ; Adult ; Aged ; Bone Neoplasms/mortality/*secondary/therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Nasopharyngeal Neoplasms/mortality/*pathology/therapy ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate ; Young Adult

OBJECTIVETo develop a new noninvasive limb-salvaging method in the treatment of primary malignant bone tumor in the extremities.

METHODSForty-four patients with primary malignant bone tumor were treated by extracorporal high intensity focused ultrasound (HIFU) with or without chemotherapy, with a mean follow-up of 17.6 months.

RESULTSThe overall survival and complication rates were 84.1% and 18.2%. In 34 patients with stage II b disease, 30 were disease-free, with 2 died of tumor metastasis to brain and lung and 3 developed local recurrence. In 10 patients with stage III b disease, 5 survived with tumor, with 1 developed local recurrence and 5 died of lung metastasis. Thirty-six of 44 patients were > or = 15 points by Enneking system.

CONCLUSIONHigh intensity focused ultrasound combined with chemotherapy for primary malignant bone tumor in the extremity is proved to be effective and safe, preserving good function in the limbs. HIFU may possibly become a new limb-salvaging treatment for this tumor.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; mortality ; pathology ; therapy ; Child ; Female ; Humans ; Male ; Middle Aged ; Survival Rate ; Ultrasonic Therapy ; Ultrasound, High-Intensity Focused, Transrectal

OBJECTIVETo analyze the clinical characteristics, survival and prognosis of breast cancer patients under 30 years of age.

METHODS129 breast cancer patients under 30 years treated from Jan 1980 to May 2000 were retrospectively reviewed. Clinical features, survival and prognostic factors were analyzed by SPSS 10.0 statistic software.

RESULTSBreast cancer patients under 30 years accounted for 2.6% of all breast cancers in our hospital. The overall 5- and 10-year survival rates were 61.5% and 46.7%, respectively. For patients with tumor < or = 3 cm or > 3 cm, the 10-year survival rates were 65.5% and 27.4% (P < 0.01). For those with number of positive axillary lymph nodes 0, 1-3, or > or = 4, the 10-year survival rates were 79.5%, 40.9% or 31.4% (P < 0.01). For patients who had been treated with or without tamoxifen, the 10-year survival rates were 63.7% and 45% (P < 0.01). For those complicated with pregnancy and lactation which was found in 24.8% of such patients, the 10-year survival rate was 44.3%. In the multivariate analysis, independent prognostic factors that might improve the overall survival were tumor size, axillary metastatic status and tamoxifen treatment.

CONCLUSIONBreast cancer patients aged 30 years and younger may have good prognosis if multimodality treatment is given. Tumor size, axillary metastatic status and tamoxifen treatment are independent prognostic factors. Prognosis of patients, either complicated with pregnancy and lactation or not, is quite similar if the clinical stage is the same and if being treated by the combined therapy.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; secondary ; Breast Neoplasms ; mortality ; pathology ; therapy ; Carcinoma, Ductal, Breast ; mortality ; secondary ; therapy ; Carcinoma, Medullary ; mortality ; secondary ; therapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Lactation ; Lung Neoplasms ; secondary ; Mastectomy ; methods ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; therapy ; Prognosis ; Retrospective Studies ; Survival Rate ; Tamoxifen ; administration & dosage

BACKGROUND: Primary lymphoma of bone is a rare disease. There is yet no systematical evaluation of primary lymphoma of bone in Korea. Here we report our experience of sixteen cases with primary lymphoma of bone focusing on the survival. METHODS: Sixteen cases, collected for 13 years, were evaluated on the clinical presentation, histologic subtype, stage and treatment outcomes of the primary bone lymphoma. RESULTS: The most common presenting complaint was bone pain. Malignant lymphoma of bone involved a wide variety of sites, the most prevalent site of which in this study was the spine. Most of the cases were in the diffuse large B-cell category. The clinical stage of lymphoma was IEA in two cases, IIEA in three cases, IVEA in five cases and IVEB in three cases. All treated cases received systemic chemotherapy and ten cases among them were treated with combined modality therapy. Median overall survival was not reached after median follow-up period of 28 months and five-year overall survival rate was 54%. CONCLUSION: More promising therapeutic strategies are needed for survival improvement on more accumulated cases.
Adolescent ; Adult ; Aged ; Bone Neoplasms/*mortality/pathology/therapy ; Child ; Child, Preschool ; Female ; Human ; Infant ; Korea/epidemiology ; Lymphoma/*mortality/pathology/therapy ; Male ; Middle Age ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate

Change in tumor volume after chemotherapy appears to have a prognostic significance for the outcome of osteosarcoma. A newly developed volume measurement method based on three-dimensional summation with a proved reproducibility was utilized to measure osteosarcoma tumor volume. This retrospective analysis included 38 patients with biopsy- proven, nonsurface, skeletal high-grade osteosarcoma. The treatment was started by using three cycles of preoperative chemotherapy with cisplastin (100 mg/m2) and adriamycin (30 mg/m2). The tumor volume was measured before and after preoperative chemotherapy using three-dimensional magnetic resonance image measurement. The percentage of tumor necrosis was assessed by pathologic exam. After three cycle of postoperative chemotherapy, the patients were followed up at regular interval. For the 23 good responder patients, the mean survival time was 73.2 months (95% confidence interval 61.9 - 84.5 months), and for the 15 poor responder patients, the mean survival time was 50.8 months (95% confidence interval 38.6 - 63.1 months) (p < 0.05). For the 14 patients with increased tumor volume after chemotherapy, the mean survival time was 47.5 months (range: 36.3 - 58.6 months) and for the 24 patients with stable or decreased tumor volume, the mean survival time was 74.3 months (range: 63.79 - 84.88 months) (p < 0.05). Among the various factors, histopathologic response and tumor volume change after chemotherapy predicted disease free survival (p < 0.05). Change in the tumor volume that was measured with a reproducible method and the histopathologic response after chemotherapy were the important predictors of disease free survival for osteosarcoma patients.
Antibiotics, Antineoplastic/therapeutic use ; Antineoplastic Agents/therapeutic use ; Bone Neoplasms/drug therapy/*mortality/*pathology ; Cisplatin/therapeutic use ; Disease-Free Survival ; Doxorubicin/therapeutic use ; Humans ; Osteosarcoma/drug therapy/*mortality/*pathology ; Predictive Value of Tests ; Prognosis ; Retrospective Studies

Despite increasing evidence that high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT) might improve the survival of patients with high-risk or recurrent solid tumors, therapy effectiveness for bone and soft tissue sarcoma treatment remains unclear. This study retrospectively investigated the feasibility and effectiveness of HDCT/auto-SCT for high-risk or recurrent bone and soft tissue sarcoma. A total of 28 patients (18 high-risk and 10 recurrent) underwent single or tandem HDCT/auto-SCT between October 2004 and September 2014. During follow-up of a median 15.3 months, 18 patients exhibited disease progression and 2 died of treatment-related toxicities (1 veno-occlusive disease and 1 sepsis). Overall, 8 patients remained alive and progression-free. The 3-year overall survival (OS) and event-free survival (EFS) rates for all 28 patients were 28.7% and 26.3%, respectively. In the subgroup analysis, OS and EFS rates were higher in patients with complete or partial remission prior to HDCT/auto-SCT than in those with worse responses (OS, 39.1% vs. 0.0%, P = 0.002; EFS, 36.8% vs. 0.0%, P < 0.001). Therefore, careful selection of patients who can benefit from HDCT/auto-SCT and maximal effort to reduce tumor burden prior to treatment will be important to achieve favorable outcomes in patients with high-risk or recurrent bone and soft tissue sarcomas.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Bone Neoplasms/mortality/pathology/*therapy ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Retrospective Studies ; Sarcoma/mortality/pathology/*therapy ; Soft Tissue Neoplasms/mortality/pathology/*therapy ; *Stem Cell Transplantation ; Survival Rate ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

OBJECTIVE: The aim of the study was to establish a predictive model of survival period after bone metastasis from cervical cancer. METHODS: A total of 54 patients with bone metastasis from cervical cancer were included in the study. Data at the time of bone metastasis diagnosis, which included presence of extraskeletal metastasis, performance status, history of any previous radiation or chemotherapy, the number of bone metastases, onset period, and treatment were collected. Survival data were analyzed using Kaplan-Meier method and Cox proportional hazards model. RESULTS: The median survival period after diagnosis of bone metastasis was 22 weeks (5 months). The 26- and 52-week survival rates after bone metastasis were 36.5% and 15.4%, respectively. Cox regression analysis showed that extraskeletal metastasis (hazard ratio [HR], 6.1; 95% CI, 2.2 to 16.6), performance status of 3 to 4 (HR, 7.8; 95% CI, 3.3 to 18.2), previous radiation or chemotherapy (HR, 3.3; 95% CI, 1.4 to 7.8), multiple bone metastases (HR, 1.9; 95% CI, 1.0 to 3.5), and a bone metastasis-free interval of <12 months (HR, 2.5; 95% CI, 1.2 to 5.3) were significantly and independently related to poor survival. A prognostic score was calculated by adding the number of each significant factor. The 26-week survival rates after diagnosis of bone metastasis were 70.1% in the group with a score ≤2, 46.7% in the group with a score of 3, and 12.5% in the group with a score ≥4 (p<0.001). CONCLUSION: This scoring system provided useful prognostic information on survival of patients with bone metastasis of cervical cancer.
Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms/*mortality/*secondary/therapy ; Female ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Neoplasm Staging ; Proportional Hazards Models ; Survival Rate ; United States/epidemiology ; Uterine Cervical Neoplasms/*pathology/therapy