Aims. The modified Glasgow Prognostic Score (mGPS) uses preoperative CRP and albumin to calculate a score from 0 to 2 (2 being associated with poor outcomes). mGPS is validated in multiple carcinomas. To date, its use in soft-tissue sarcoma (STS) is limited, with only small cohorts reporting that increased mGPS scores correlates with decreased survival in STS patients. Methods. This retrospective multicentre cohort study identified 493 STS patients using clinical databases from six collaborating hospitals in three countries. Centres performed a retrospective data collection for patient demographics, preoperative blood results (CRP and albumin levels and neutrophil,
The aims of this study were to evaluate the incidence
of local argyria in patients with silver-coated megaprostheses and
to identify a possible association between argyria and elevated
levels of silver both locally and in the blood. Between 2004 and
2011, 32 megaprostheses with silver coatings were implanted in 20
female and 12 male patients following revision arthroplasty for
infection or resection of a malignant tumour, and the levels of
silver locally in drains and seromas and in the blood were determined.
The mean age of the patients was 46 years (10 to 81); one patient
died in the immediate post-operative period and was excluded. Seven patients (23%) developed local argyria after a median of
25.7 months (interquartile range 2 to 44.5). Patients with and without
local argyria had comparable levels of silver in the blood and aspiration
fluids. The length of the implant did not influence the development
of local argyria. Patients with clinical evidence of local argyria
had no neurological symptoms and no evidence of renal or hepatic
failure. Thus, we conclude that the short-term surveillance of blood
silver levels in these patients is not required. Cite this article:
We studied the safety of external fixation during post-operative chemotherapy in 28 patients who had undergone distraction osteogenesis (17, group A) or vascularised fibular grafting (11, group B) after resection of a tumour. Four cycles of multi-agent post-operative chemotherapy were administered over a mean period of 14 weeks (6 to 27). The mean duration of external fixation for all patients was 350 days (91 to 828). In total 204 wires and 240 half pins were used. During the period of post-operative chemotherapy, 14 patients (11 in group A, 3 in group B) developed wire- and pin-track infection. A total of ten wires (4.9%) and 11 half pins (4.6%) became infected. Seven of the ten infected wires were in periarticular locations. External fixation during post-operative chemotherapy was used safely and successfully for fixation of a vascularised fibular graft and distraction osteogenesis in 27 of 28 patients. Post-operative chemotherapy for malignant bone tumours did not adversely affect the ability to achieve union or cause hypertrophy of the vascularised fibular graft and had a minimal effect on distraction osteogenesis. Only one patient developed osteomyelitis which required further surgery.