INTRODUCTION: The most recent local study on the incidence of histological subtypes of all brain and spinal tumours treated surgically was published in 2000. In view of the outdated data, we investigated the presenting characteristics, histological subtypes and outcomes of adult patients who underwent surgery for brain or spinal tumours at our institution. METHODS: A single-centre retrospective review of 501 patients who underwent surgery for brain or spinal tumours from 2016 to 2020 was conducted. The inclusion criteria were (a) patients who had a brain or spinal tumour that was histologically verified and (b) patients who were aged 18 years and above at the time of surgery. RESULTS: Four hundred and thirty-five patients (86.8%) had brain tumours and 66 patients (13.2%) had spinal tumours. Patients with brain tumours frequently presented with cranial nerve palsy, headache and weakness, while patients with spinal tumours frequently presented with weakness, numbness and back pain. Overall, the most common histological types of brain and spinal tumours were metastases, meningiomas and tumours of the sellar region. The most common complications after surgery were cerebrospinal fluid leak, diabetes insipidus and urinary tract infection. In addition, 15.2% of the brain tumours and 13.6% of the spinal tumours recurred, while 25.7% of patients with brain tumours and 18.2% of patients with spinal tumours died. High-grade gliomas and metastases had the poorest survival and highest recurrence rates. CONCLUSION This study serves as a comprehensive update of the epidemiology of brain and spinal tumours and could help guide further studies on brain and spinal tumours.
Humans ; Retrospective Studies ; Female ; Male ; Middle Aged ; Adult ; Aged ; Central Nervous System Neoplasms/pathology* ; Brain Neoplasms/pathology* ; Treatment Outcome ; Postoperative Complications ; Young Adult ; Spinal Neoplasms/pathology* ; Neoplasm Recurrence, Local ; Aged, 80 and over ; Adolescent

Prostate cancer represents a prevalent malignancy within the male genitourinary system. In recent years, its incidence in China has gradually increased, becoming a significant public health issue. While early detection correlates strongly with improved prognosis, the majority of newly diagnosed prostate cancer patients in China are already in intermediate or advanced stages, precluding curative-intent interventions and contributing to marked survival disparities. The progression of prostate cancer is lengthy, typically encompassing diagnosis, treatment, progression, metastasis, and death, accompanied by a decline in quality of life. Personalized treatment plans should be developed based on the disease stage and patient preferences. In non-metastatic prostate cancer, where the tumor is confined to the prostate, surgery and radiotherapy are the primary treatments, supplemented by neoadjuvant and adjuvant therapies to delay metastasis. For metastatic prostate cancer, systemic therapy is prioritized to prolong survival. In metastatic hormone-sensitive prostate cancer, controlling androgen levels is crucial, while treatment options for metastatic castration resistant prostate cancer are relatively limited, necessitating individualized and precise treatment. During prostate cancer management, prostate-specific antigen levels are closely linked to prognosis and require monitoring. Bone metastasis, the most common site in prostate cancer patients, often triggers skeletal-related events, demanding effective prevention and management. Treatment-related adverse reactions are also a clinical challenge, requiring balanced risk-benefit assessments and judicious drug selection to preserve quality of life. Rapid advancements in screening technologies, surgical innovations, drug development, and China-specific epidemiological factors further complicate decision-making in holistic prostate cancer management. To optimize the standardization of prostate cancer diagnosis and treatment in China, the Genitourinary Oncology Committee of Chinese Anti-cancer Association synthesized global guidelines, clinical evidence and clinical expertise, and addressed critical challenges in the whole-course management of prostate cancer to formulate a multidisciplinary consensus. The expert consensus on whole-course management of prostate cancer (2025 edition) establishes standardized protocols to guide clinical practice, improve treatment outcomes, and enhance patient quality of life.
Humans ; Male ; Prostatic Neoplasms/diagnosis* ; Consensus ; Prostate-Specific Antigen/blood* ; Quality of Life ; Prostatic Neoplasms, Castration-Resistant/pathology* ; China ; Bone Neoplasms/secondary* ; Androgen Antagonists/therapeutic use*

The paper reports acupuncture treatment for one case of oculomotor nerve palsy after cranial-orbital communicating tumor surgery. The acupoint prescription was composed of the local acupoints of the eyes (Yansanzhen, Tijian, Cuanzhu [BL2], Yuyao [EX-HN4] and Sizhukong [TE23]), the acupoints on the head, face and neck (Yangbai [GB14], Sibai [ST2] and Fengchi [GB20]), Guanyuan (CV4) on the abdomen, and those on the four limbs (Hegu [LI4], Zusanli [ST36], Shenmai [BL62] and Zhaohai [KI6]). The point-to-point needling technique with the eyelid lifted was operated at Tijian, Cuanzhu (BL2), Yuyao (EX-HN4), and Sizhukong (TE23). Warm needling with moxa cone placed on the needle handle was operated at Guanyuan (CV4) and Zusanli (ST36), and the usual needling technique was delivered at the rest acupoints. The treatment was given once daily, discontinued for 1 day after every 6 treatments. One course of treatment was composed of 7 days, and 6 courses were required. After treatment completion, the upper eyelids were basically symmetrical and the bilateral eye cracks were equal, the double vision appeared occasionally. No recurrence and no aggravation were reported in 1 month of follow up visit.
Humans ; Acupuncture Points ; Acupuncture Therapy ; Oculomotor Nerve Diseases/etiology* ; Orbital Neoplasms/surgery* ; Postoperative Complications/etiology*

This study aims to investigate the optimal ratio of Astragali Radix-Curcumae Rhizoma(AC) for inhibiting the proliferation of 143B osteosarcoma cells, and to investigate the mechanism by which AC inhibits osteosarcoma growth and metastasis through angiogenesis and cell adhesion mediated by the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/hypoxia inducible factor-1α(HIF-1α) pathway. A subcutaneous 143B tumor-bearing nude mouse model was successfully established and randomly divided into the model group, and the AC 1∶1, 2∶1, and 4∶1 groups. Body weight, tumor volume, and tumor weight were recorded. Real-time quantitative polymerase chain reaction(RT-qPCR) and Western blot were used to detect the mRNA and protein expression levels of PI3K, Akt, phosphorylated Akt(p-Akt), HIF-1α, vascular endothelial growth factor A(VEGFA), transforming growth factor-β1(TGF-β1), epithelial cadherin(E-cadherin), neural cadherin(N-cadherin), vimentin, matrix metalloproteinase 2(MMP2), matrix metalloproteinase 9(MMP9), B-cell lymphoma-2(Bcl-2), Bcl-2-associated X protein(Bax), and caspase-3 in the hypoxic core region of the tumor tissue. A cell hypoxia model was established, and the effects of AC-medicated serum(model group, AC 1∶1, 2∶1, and 4∶1 groups) on angiogenesis, proliferation, adhesion, invasion, and migration of 143B osteosarcoma cells were examined through CCK-8, flow cytometry, Transwell assay, cell adhesion assay, and HUVEC tube formation assay. The results showed that compared with the model group, the tumor weight and volume were smallest in the 2∶1 group. The expression levels of PI3K, Akt, p-Akt, HIF-1α, VEGFA, and TGF-β1 were significantly decreased, and the protein expression of E-cadherin was significantly increased, while the protein expression of N-cadherin, vimentin, MMP2, and MMP9 was significantly decreased. Additionally, the protein expression of Bax and caspase-3 was significantly increased, and Bcl-2 protein expression was significantly decreased. In vitro experiments showed that after intervention with AC-medicated serum at a 2∶1 ratio, the cell activity, adhesion, invasion, and migration of 143B cells were significantly reduced, apoptosis was significantly increased, and HUVEC tube formation was significantly decreased. In conclusion, the 2∶1 ratio of AC showed the most effective inhibition of 143B cell growth. AC can inhibit the growth and metastasis of osteosarcoma 143B cells by regulating the PI3K/Akt/HIF-1α signaling pathway, inhibiting angiogenesis and reducing cell adhesion, invasion, and migration.
Osteosarcoma/pathology* ; Animals ; Proto-Oncogene Proteins c-akt/genetics* ; Hypoxia-Inducible Factor 1, alpha Subunit/genetics* ; Humans ; Mice ; Cell Adhesion/drug effects* ; Cell Proliferation/drug effects* ; Neovascularization, Pathologic/metabolism* ; Drugs, Chinese Herbal/administration & dosage* ; Phosphatidylinositol 3-Kinases/genetics* ; Cell Line, Tumor ; Mice, Nude ; Signal Transduction/drug effects* ; Astragalus Plant/chemistry* ; Bone Neoplasms/physiopathology* ; Male ; Rhizome/chemistry* ; Mice, Inbred BALB C ; Angiogenesis

OBJECTIVES: This systematic review examines recent pharmacoeconomic literature on denosumab' cost-effectiveness for bone metastasis treatment, providing evidence-based insights to guide healthcare policy decisions. METHODS: A comprehensive literature search was performed across Cochrane, PubMed, EMBASE (Ovid), CNKI, and Wanfang databases to identify original articles published between 2017 and 2023. Key words consisted of bone metastases, denosumab, and cost-effectiveness in the search strategy. The methodological quality of the included studies was assessed utilizing the revised Consolidated Health Economic Evaluation Reporting Standards (CHEERS 2022). Data was extracted regarding methodological characteristics and cost-effectiveness analyses. RESULTS: A total of 111 studies were retrieved, of which 6 met the inclusion criteria. All included studies were based on clinical trials and published literature data and exhibited high methodological quality. Up to 83% (5 out of 6) of comparisons demonstrated that denosumab was more cost-effective or dominant compared to zoledronic acid. The adjusted incremental cost-effectiveness ratios varied substantially by tumor type, ranging from CZK 436,339.09 to USD 136,234 per skeletal-related event avoided and from CZK 61,580.95 to USD 118,392.11 per quality-adjusted life year gained. CONCLUSIONS The majority of the included studies support denosumab as a more cost-effective treatment option for bone metastases in solid tumors compared to zoledronic acid. The application of CHEER (2022) enhances the reliability of pharmacoeconomic evaluations.
Denosumab/therapeutic use* ; Humans ; Bone Neoplasms/economics* ; Cost-Benefit Analysis

OBJECTIVE: To investigate the effectiveness of posterior lateral perforator flap in lower limb combined with free fibula for maxillary tissue defect repair. METHODS: Between December 2018 and December 2023, 16 patients with the maxillary malignant tumors were admitted. There were 10 males and 6 females, with an average age of 64.3 years (range, 54-75 years). There were 7 cases of maxillary gingival cancer, 5 cases of hard palate cancer, and 4 cases of maxillary sinus cancer. According to the 2017 American Joint Committee on Cancer (AJCC) TNM stage, there were 8 cases of stage Ⅲ, 6 cases of stage Ⅳa, and 2 cases of stage Ⅳb. After resection of the lesion, the remaining maxillary defects were classified into class Ⅱa in 3 cases, class Ⅱb in 5 cases, and class Ⅲb in 8 cases according to Brown's classification. The size of soft tissue defects ranged from 4 cm×3 cm to 8 cm×6 cm. The posterior lateral perforator flap in lower limb in size of 5 cm×4 cm-9 cm×7 cm were harvested to repair soft tissue defects, and free fibula in length of 6-11 cm were used to repair bone defects. The donor sites of the lower limb were sutured directly (6 cases) or repaired with free skin grafting (10 cases). Six patients with positive lymph node pathology were treated with radiotherapy after operation. At 6 and 12 months after operation, the self-assessment was performed by the University of Washington Quality of Survival Questionnaire Form (QUW-4) in five dimensions (facial appearance, swallowing function, chewing function, speech function, and mouth opening), and swallowing function was evaluated by using the Kubota water swallowing test. RESULTS: Postoperative pathological examination showed that all patients were squamous cell carcinoma. One patient who was treated with radiotherapy developed osteomyelitis and 1 patient developed venous crisis of skin flap. The rest of the flaps and all skin grafts survived, and the wounds healed by first intention. All patients were followed up 1-5 years (mean, 2.8 years). Two patients died of local recurrence of the tumor at the 4th and 5th years after operation, respectively. Except for the chewing function score and total score at 6 months after operation, which showed significant differences compared to preoperative scores ( P<0.05), there was no significant difference in other QUW-4 scale scores between different time points ( P>0.05). The patients' swallowing function evaluated by Kubota water swallowing test reached normal in 4 cases, suspicious in 9 cases, and abnormal in 3 cases at 6 months after operation, and 10, 6, and 0 cases at 12 months after operation, respectively. The swallowing function at 12 months was significantly better than that at 6 months ( Z=-2.382, P=0.017). CONCLUSION The posterior lateral perforator flap in the lower limb combined with free fibula to repair maxillary tissue defects can repair soft and hard tissue defects at the same time, so that the patient's facial appearance, swallowing function, chewing function, speech function, and mouth opening are satisfactorily restored and the mid-term effectiveness is good.
Humans ; Middle Aged ; Male ; Female ; Fibula/surgery* ; Aged ; Perforator Flap ; Plastic Surgery Procedures/methods* ; Maxilla/surgery* ; Maxillary Neoplasms/surgery* ; Free Tissue Flaps/transplantation* ; Lower Extremity/surgery* ; Bone Transplantation/methods* ; Treatment Outcome

Primary malignant bone tumors are extremely rare. Osteosarcoma, chondrosarcoma, Ewing's sarcoma, and myeloma are the most common malignancy in bone. Osteosarcoma and Ewing's sarcoma are common in children and adolescents, and the tumors are high lethality due to the high rate of pulmonary metastasis. While chondrosarcoma, myeloma, and chordoma are more common in middle aged and elderly people. Japanese Orthopaedic Association (JOA) published the secondary clinical practice guideline on the management of primary malignant bone tumors. We put an emphasis on explanation some important issue of this guideline for help Chinese musculoskeletal tumor professionals in clinical practice.
Humans ; Bone Neoplasms/surgery* ; Chondrosarcoma/therapy* ; Japan ; Orthopedics ; Osteosarcoma/pathology* ; Practice Guidelines as Topic ; Sarcoma, Ewing/therapy* ; Societies, Medical

OBJECTIVE: To explore the effectiveness of artificial hemi-knee prosthesis reconstruction for bone defects after resection of pediatric osteosarcoma. METHODS: A retrospective analysis was conducted on the clinical data of 18 children with osteosarcoma who met the selection criteria and were treated between January 2016 and December 2019. There were 11 males and 7 females, aged 6-10 years (mean, 8.9 years). Osteosarcoma located in the distal femur in 11 cases and the proximal tibia in 7 cases. Among them, 12 cases were conventional osteosarcoma and 6 cases were small cell osteosarcoma, with a disease duration of 1-9 months (mean, 3.1 months). All patients received 2 cycles of preoperative chemotherapy with doxorubicin, cisplatin, and ifosfamide. After en bloc tumor segment resection, bone defects were reconstructed using custom-made artificial hemi-knee prostheses. Rehabilitation training was initiated at 8 weeks postoperatively under the protection of a knee immobilizer brace, combined with 4 cycles of adjuvant chemotherapy. During follow-up, lower limb growth length and limb shortening (compared with the healthy side) were measured, and limb function was evaluated using the Musculoskeletal Tumor Society-93 (MSTS-93) scoring system. RESULTS: All surgeries were successfully completed, with an operation time of 2.0-3.1 hours (mean, 2.4 hours) and intraoperative blood loss of 180-320 mL (mean, 230.0 mL). Incisional edge necrosis occurred in 1 case at 10 days postoperatively, while the incisions of the remaining 17 patients healed by first intention. One case developed periprosthetic infection caused by Staphylococcus aureus at 1 week postoperatively, which was cured after symptomatic treatment. All 18 patients were followed up 60-96 months (mean, 74.2 months). No local tumor recurrence was observed during follow-up. Imaging examinations showed prosthesis loosening in 2 cases, while the prosthesis of other patients were well-positioned. At last follow-up, the knee joint range of motion was 80°-120° (mean, 106.7°). The MSTS-93 score was 16-29 (mean, 24.7), with 12 cases rated as excellent, 5 good, and 1 fair. The patients' height increased by 12.8-20.0 cm (mean, 15.5 cm), the lower limb growth length was 6.0-13.0 cm (mean, 9.7 cm), and limb shortening was 1.8-4.6 cm (mean, 3.1 cm). There was no significant difference in MSTS-93 scores, lower limb growth length, or limb shortening between the distal femur group and the proximal tibia group ( P>0.05). CONCLUSION Artificial hemi-knee prosthesis reconstruction can preserve the adjacent normal epiphysis of the knee joint, maximize limb growth potential, and reduce adult limb length discrepancy, making it a suitable reconstruction option for children with knee osteosarcoma.
Humans ; Osteosarcoma/surgery* ; Male ; Child ; Female ; Knee Prosthesis ; Retrospective Studies ; Bone Neoplasms/surgery* ; Plastic Surgery Procedures/methods* ; Tibia/surgery* ; Femur/surgery* ; Arthroplasty, Replacement, Knee/methods* ; Treatment Outcome ; Chemotherapy, Adjuvant ; Femoral Neoplasms/surgery*

OBJECTIVE: To investigate the effectiveness of three-dimensional (3D) printed customized hemi-pelvic prosthesis for pelvic reconstruction after resection of massive pelvic tumors. METHODS: A retrospective analysis was conducted on 26 patients with massive pelvic tumors who met the selection criteria and were treated between November 2021 and May 2024. The cohort included 11 males and 15 females, with a mean age of 52.65 years (range, 17-73 years). Histopathological diagnoses were as follows: 9 cases of chondrosarcoma, 2 of undifferentiated pleomorphic sarcoma, 4 of spindle cell sarcoma, 2 of osteosarcoma, 1 of solitary fibrous tumor, 1 of myxoid chondroma, 1 of malignant peripheral nerve sheath tumor, 1 of chondromyxoid epithelioma, and 5 of metastatic malignant tumors. According to the Enneking classification, tumor involvement was distributed as 4 cases in zones Ⅰ+Ⅱ, 9 in zones Ⅱ+Ⅲ, 3 in zones Ⅰ+Ⅳ, 8 in zones Ⅰ+Ⅱ+Ⅲ, and 2 in zones Ⅰ+Ⅱ+Ⅳ. The disease duration ranged from 3 to 40 months, with a mean of 9.85 months. All patients underwent reconstruction with customized 3D-printed hemi-pelvic prostheses. The effectiveness was evaluated by Musculoskeletal Tumor Society (MSTS) score and Harris hip score before operation and at last follow-up, and pain levels were evaluated by visual analogue scale (VAS) score before operation, at 3 months after operation, and at last follow-up. RESULTS: The operation time ranged from 186 to 528 minutes, with a mean of 334.58 minutes. The intraoperative blood loss ranged from 1 400 to 4 000 mL, with a mean of 2173.08 mL, and the transfusion volume ranged from 750 to 3 500 mL, with a mean of 1 659.62 mL. All 26 patients were followed up 10-42 months (mean, 18.5 months). Postoperative complications included prosthetic dislocation in 2 cases, which were attributed to improper positioning during home care and an accidental fall, respectively. One patient developed a vesicocutaneous fistula and poor wound healing due to pre-existing tumor invasion into the bladder. One patient experienced failure and loosening of the internal fixation at 8 months after operation caused by local tumor recurrence, and subsequently died at 14 months postoperatively due to progression of brain metastases. Postoperative complications such as poor healing of incisions, prosthetic dislocation, or failure of internal fixation was not observed in the remaining patients. At last follow-up, the walking ability of most patients recovered to varying degrees. The VAS scores at 3 months and at last follow-up significantly improved when compared with those before operation, and the scores at last follow-up further improved when compared with 3 months after operation, all showing significant differences ( P<0.05). The MSTS scores and Harris scores at last follow-up were significantly higher than those before operation ( P<0.05). CONCLUSION 3D printed customized hemi-pelvic prosthesis is effective for reconstruction of massive pelvic tumors after resection, but there are still some limitations, and soft tissue reconstruction should be paid attention to.
Humans ; Printing, Three-Dimensional ; Female ; Male ; Adult ; Plastic Surgery Procedures/methods* ; Retrospective Studies ; Middle Aged ; Aged ; Pelvic Bones/surgery* ; Bone Neoplasms/surgery* ; Adolescent ; Pelvic Neoplasms/surgery* ; Prosthesis Design ; Young Adult ; Treatment Outcome ; Prostheses and Implants

OBJECTIVE: To explore the safety and effectiveness of separation surgery in patients with neurological symptoms of spinal metastases. METHODS: From January 2020 to December 2022, 14 patients with neurological symptoms of spinal metastases underwent separation surgery, including 7 males and 7 females, aged from 30 to 76 years old with an average of (61.57±12.16) years old. In comparison with eleven patients underwent conservative treatment during the same period, including 6 males and 5 femals, aged from 46 to 88 years old with an average of (66.55±12.32) years old. The changes in visual analogue scale (VAS), Frankel grades, Karnofsky scores, and quality of life score (QOL) before and after treatment were compared between two groups. RESULTS: Fourteen patients in the separation surgery group underwent surgery successfully, with surgery time of (218.57±50.00) minutes and intraoperative blood loss of (864.29±332.97) ml, 2 patients developed delayed hematoma and recovered well finally after emergency surgery, the follow-up time was 3 to 36 months, after separation surgery, the pain was significantly relieved, and neurological function recovered well in the patients. Three months after treatment, the VAS in the separation surgery group (1.43±0.76) scores was significantly lower than that in the conservative treatment group (8.64±0.51) scores (P<0.05);and the Frankel grades, Karnofsky scores, and QOL scores in the separation surgery group were significantly better than those in the conservative treatment group(P<0.05). CONCLUSION For patients with obvious neurological symptoms of spinal metastases, separation surgery not only can rapidly relieve nerve compression but also carry relatively low surgical risks, and improve the quality of life of patients.
Humans ; Female ; Male ; Middle Aged ; Aged ; Spinal Neoplasms/complications* ; Adult ; Aged, 80 and over ; Quality of Life