The aim of this study was to determine whether
the high-sensitivity modified Glasgow prognostic score (Hs-mGPS) could
predict the disease-specific survival and oncological outcome in
adult patients with non-metastatic soft-tissue sarcoma before treatment.
A total of 139 patients treated between 2001 and 2012 were retrospectively reviewed.
The Hs-mGPS varied between 0 and 2. Patients with a score of 2 had
a poorer disease-specific survival than patients with a score of
0 (p <
0.001). The estimated five-year rate of disease-specific
survival for those with a score of 2 was 0%, compared with 85.4%
(95% CI 77.3 to 93.5) for those with a score of 0. Those with a
score of 2 also had a poorer disease-specific survival than those
with a score of 1 (75.3%, 95% CI 55.8 to 94.8; p <
0.001). Patients
with a score of 2 also had a poorer event-free rate than those with
a score of 0 (p <
0.001). Those with a score of 2 also had a
poorer event-free survival than did those with a score of 1 (p =
0.03). A multivariate analysis showed that the Hs-mGPS remained
an independent predictor of survival and recurrence. The Hs-mGPS
could be a useful prognostic marker in patients with a soft-tissue
sarcoma. Cite this article:
The aim of this study was to define the incidence
of venous thromboembolism (VTE) and risk factors for the development
of deep-vein thrombosis (DVT) after the resection of a musculoskeletal
tumour. A total of 94 patients who underwent resection of a musculoskeletal
tumour between January 2003 and December 2005 were prospectively
studied. There were 42 men and 52 women with a mean age of 54.4
years (18 to 86). All patients wore intermittent pneumatic compression
devices and graduated compression stockings. Ultrasound examination
of the lower limbs was conducted to screen for DVT between the fifth
and ninth post-operative days. DVT was detected in 21 patients (22%). Of these, two were symptomatic
(2%). One patient (1%) had a fatal pulmonary embolism. Patients
aged ≥ 70 years had an increased risk of DVT (p = 0.004). The overall incidence of DVT (both symptomatic and asymptomatic)
after resection of a musculoskeletal tumour with mechanical prophylaxis
was high. It seems that both mechanical and anticoagulant prophylaxis
is needed to prevent VTE in patients who have undergone the resection
of a musculoskeletal tumour. Cite this article:
Limb salvage involving wide resection and reconstruction is now well established for managing musculoskeletal sarcomas. However, involvement of major nerves and vessels with a large volume of muscle and skin may result in a useless limb, contributing to depression and a low quality of life. We have been studying alternative treatments for musculoskeletal sarcoma since 1990, and have recently established a regime using photodynamic surgery with cells labelled with acridine orange, photodynamic therapy with cells treated similarly and radiodynamic treatment using the effect of X-rays on such cells. These techniques have been used after marginal or intralesional resection of tumours since 1999 and have enabled maintenance of excellent limb function in patients with sarcomas.
We studied the precise role of the fracture haematoma in healing by the experimental transplantation of the haematoma at two days and four days after fracture of the rat femur to subperiosteal and intramuscular sites. We used bone marrow and peripheral blood haematomas for control experiments. The transplanted two-day fracture haematoma produced new bone by endochondral ossification at the subperiosteal site, but not at the intramuscular site. Four-day fracture haematoma produced new bone formation at both subperiosteal and intramuscular sites. These results suggest that fracture haematoma has an inherent osteogenetic potential.
