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Evidence-Based Treatment for Malignant Paediatric Bone Tumours

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Paediatric Orthopaedics

Abstract

In Children, the vast majority of bone tumours are benign or benign aggressive entities. For the purposes of this discussion however, we are focusing on the management of primary and secondary bone malignancies.

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References

  1. Duong LA, Richardson LC. Descriptive epidemiology of malignant primary OSA using population-based registries, United States, 1999–2008. J Registry Manag. 2013;40(2):59–64.

    PubMed  PubMed Central  Google Scholar 

  2. Luetke A, Meyers PA, Lewis I, Juergens H. OSA treatment–where do we stand? A state of the art review. Cancer Treat Rev. 2014;40(4):523–32.

    Article  PubMed  Google Scholar 

  3. Geller DS, Gorlick R. OSA: a review of diagnosis, management, and treatment strategies. Clin Adv Hematol Oncol. 2010;8(10):705–18.

    PubMed  Google Scholar 

  4. Moore DD, Luu HH. OSA. In: Orthopaedic oncology. Springer; Chicago. 2014. pp. 65–92.

    Google Scholar 

  5. Group ESESNW. Bone sarcomas: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012;23(suppl 7):vii100–9.

    Google Scholar 

  6. Larizza L, Roversi G, Volpi L. Rothmund-thomson syndrome. Orphanet J Rare Dis. 2010;5(2).

    Google Scholar 

  7. Henderson TO, Rajaraman P, Stovall M, Constine LS, Olive A, Smith SA, et al. Risk factors associated with secondary sarcomas in childhood cancer survivors: a report from the childhood cancer survivor study. Int J Radiat Oncol Biol Phys. 2012;84(1):224–30.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Meazza C, Luksch R, Daolio P, Podda M, Luzzati A, Gronchi A, et al. Axial skeletal OSA: a 25-year monoinstitutional experience in children and adolescents. Med Oncol. 2014;31(4):1–6.

    Article  Google Scholar 

  9. Bacci G, Ferrari S, Bertoni F, Ruggieri P, Picci P, Longhi A, et al. Long-term outcome for patients with nonmetastatic OSA of the extremity treated at the istituto ortopedico rizzoli according to the istituto ortopedico rizzoli/OSA-2 protocol: an updated report. J Clin Oncol. 2000;18(24):4016–27.

    CAS  PubMed  Google Scholar 

  10. Willeumier J, Fiocco M, Nout R, Dijkstra S, Aston W, Pollock R, et al. High-grade soft tissue sarcomas of the extremities: surgical margins influence only local recurrence not overall survival. Int Orthop. 2015:1–7.

    Google Scholar 

  11. Iwamoto Y. Diagnosis and treatment of Ewing’s sarcoma. Jpn J Clin Oncol. 2007;37(2):79–89.

    Article  PubMed  Google Scholar 

  12. Ross KA, Smyth NA, Murawski CD, Kennedy JG. The biology of ewing sarcoma. ISRN Oncol. 2013;2013.

    Google Scholar 

  13. Balamuth NJ, Womer RB. Ewing’s sarcoma. Lancet Oncol. 2010;11(2):184–92.

    Article  CAS  PubMed  Google Scholar 

  14. Bernstein M, Kovar H, Paulussen M, Randall RL, Schuck A, Teot LA, et al. Ewing’s sarcoma family of tumors: current management. Oncologist. 2006;11(5):503–19.

    Article  CAS  PubMed  Google Scholar 

  15. Dehal A, Copeland H, Kheradpour A, Martin M, Wallen J, Zaheer S. Ewing’s Sarcoma of the sternum: a case report and literature review. J Surg [Jurnalul de Chirurgie]. 2014;10(15):67–9.

    Google Scholar 

  16. Springfield DS, Rosenberg AE, Mankin HJ, Mindell ER. Relationship between osteofibrous dysplasia and ADA. Clin Orthop Relat Res. 1994;309:234–44.

    Google Scholar 

  17. Keeney GL, Unni KK, Beabout JW, Pritchard DJ. ADA of long bones. A clinicopathologic study of 85 cases. Cancer. 1989;64(3):730–7.

    Article  CAS  PubMed  Google Scholar 

  18. Taylor RM, Kashima TG, Ferguson DJ, Szuhai K, Hogendoorn PC, Athanasou NA. Analysis of stromal cells in osteofibrous dysplasia and ADA of long bones. Mod Pathol. 2012;25(1):56–64.

    Article  CAS  PubMed  Google Scholar 

  19. Gudaganatti SB, Jadhav MN, Patil RK, Kittur SK. Recurrent ADA of the tibia and lymph node metastasis. Medica. 2014;3(2):127.

    Google Scholar 

  20. Duan P-G, Li R-Y, Jiang Y-Q, Wang H-r, Zhou X-G, Li X-L, et al. Recurrent ADA in the thoracolumbar spine successfully treated by three-level total en bloc spondylectomy by a single posterior approach. Eur Spine J. 2014:1–8.

    Google Scholar 

  21. Haupt R, Minkov M, Astigarraga I, Schäfer E, Nanduri V, Jubran R, et al. Langerhans cell histiocytosis (LCH): guidelines for diagnosis, clinical work-up, and treatment for patients till the age of 18 years. Pediatr Blood Cancer. 2013;60(2):175–84.

    Article  PubMed  Google Scholar 

  22. Degar BA, Rollins BJ. Langerhans cell histiocytosis: malignancy or inflammatory disorder doing a great job of imitating one? Dis Model Mech. 2009;2(9–10):436–9.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Betts DR, Leibundgut KE, Feldges A. Plüss HJ, Niggli FK. Cytogenetic abnormalities in Langerhans cell histiocytosis. Br J Cancer. 1998;77(4):552.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Howarth DM, Gilchrist GS, Mullan BP, Wiseman GA, Edmonson JH, Schomberg PJ. Langerhans cell histiocytosis. Cancer. 1999;85(10):2278–90.

    Article  CAS  PubMed  Google Scholar 

  25. Nishal AJ, Modi JP, Balar HR. Langerhans cell histiocytosis. Indian J Otol. 2013;19(4):194.

    Article  Google Scholar 

  26. Picci P, Manfrini M, Fabbri N, Gambarotti M, Vanel D. Langerhans cell hystocytosis in: atlas of musculoskeletal tumors and tumorlike lesions: the rizzoli case archive. Springer Science & Business Media; Switzerland. 2014.

    Google Scholar 

  27. Langerhans L. Eosinophilic granuloma. J Bone Joint Surg Br. 2002;2002(84-B):870–2.

    Google Scholar 

  28. Eyre R, Feltbower RG, Mubwandarikwa E, Jenkinson HC, Parkes S, Birch JM, et al. Incidence and survival of childhood bone cancer in northern England and the West Midlands, 1981–2002. Br J Cancer. 2009;100(1):188–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Kivioja A, Ervasti H, Kinnunen J, Kaitila I, Wolf M, Böhling T. Chondrosarcoma in a family with multiple hereditary exostoses. J Bone Joint Surg Br. 2000;82(2):261–6.

    Article  CAS  PubMed  Google Scholar 

  30. Madan S, Robinson K, Kasliwal P, Bell M, Saleh M, Fernandes J. Limb reconstruction in Ollier’s disease. Strateg Trauma Limb Reconstr. 2015;10(1):49–54.

    Article  CAS  Google Scholar 

  31. Verdegaal SH, Bovée JV, Pansuriya TC, Grimer RJ, Ozger H, Jutte PC, et al. Incidence, predictive factors, and prognosis of chondrosarcoma in patients with Ollier disease and Maffucci syndrome: an international multicenter study of 161 patients. Oncologist. 2011;16(12):1771–9.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Reddy DSK, Kumar RK, Gali R, Kannubaddy SR, Rao M, Akheel M. Central chondrosarcoma of a pediatric mandibular condyle: a case report and review. Ann Maxillofac Surg. 2014;4(1):85.

    Article  CAS  Google Scholar 

  33. Bovée JV, Cleton-Jansen A-M, Taminiau AH, Hogendoorn PC. Emerging pathways in the development of chondrosarcoma of bone and implications for targeted treatment. Lancet Oncol. 2005;6(8):599–607.

    Article  PubMed  Google Scholar 

  34. Fabbri N, Donati D. Central chondrosarcoma. In: Atlas of musculoskeletal tumors and tumorlike lesions. Springer; Switzerland. 2014. pp. 113–7.

    Google Scholar 

  35. van Maldegem AM, Bovée JV, Gelderblom H. Comprehensive analysis of published studies involving systemic treatment for chondrosarcoma of bone between 2000 and 2013. Clinical Sarcoma Research. 2014;4(1):11.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Akpolat N, Yildirim H, Poyraz K. Sacral chondroblastic OSA misdiagnosed as chondrosarcoma and chordoma. Turkish J Med Sci. 2007;37(4):243–9.

    Google Scholar 

  37. Cheung N-KV, Dyer MA. Neuroblastoma: developmental biology, cancer genomics and immunotherapy. Nat Rev Cancer. 2013;13(6):397–411.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Brodeur GM. Neuroblastoma: biological insights into a clinical enigma. Nat Rev Cancer. 2003;3(3):203–16.

    Article  CAS  PubMed  Google Scholar 

  39. Zhao H, Cai W, Li S, Da Z, Sun H, Ma L, et al. Characterization of neuroblastoma bone invasion/metastasis in established bone metastatic model of SY5Y and KCNR cell lines. Childs Nerv Syst. 2013;29(7):1097–105.

    Article  PubMed  Google Scholar 

  40. Sohara Y, Shimada H, DeClerck YA. Mechanisms of bone invasion and metastasis in human neuroblastoma. Cancer Lett. 2005;228(1):203–9.

    Article  CAS  PubMed  Google Scholar 

  41. Picci P. OSA (osteogenic sarcoma). Orphanet J Rare Dis. 2007;2(6).

    Google Scholar 

  42. Picci P. Classic OSA. In: Atlas of musculoskeletal tumors and tumorlike lesions. Springer; Switzerland. 2014. pp. 147–52.

    Google Scholar 

  43. Stacy GS, Mahal RS, Peabody TD. Staging of bone tumors: a review with illustrative examples. Am J Roentgenol. 2006;186(4):967–76.

    Article  Google Scholar 

  44. San-Julian M, Vázquez-García BL, Sierrasesúmaga L. Limb salvage in children. Eur Surg Orthop Traumatol EFORT Textbook. 2014:4251–80.

    Google Scholar 

  45. Heymann D. Bone cancer: Primary bone cancers and bone metastases. Elsevier; San Diego, CA. 2014.

    Google Scholar 

  46. Moore DD, Haydon RC. Ewing’s sarcoma of bone. In: Orthopaedic oncology. Springer; Chicago, IL. 2014. pp. 93–115.

    Google Scholar 

  47. Franzius C, Sciuk J, Daldrup-Link HE, Jürgens H, Schober O. FDG-PET for detection of osseous metastases from malignant primary bone tumours: comparison with bone scintigraphy. Eur J Nucl Med. 2000;27(9):1305–11.

    Article  CAS  PubMed  Google Scholar 

  48. Avedian RS. Principles of musculoskeletal biopsy. In: Orthopaedic oncology. Springer; Chicago, IL. 2014. pp. 1–7.

    Google Scholar 

  49. Clark CR, Morgan C, Sonstegard DA, Matthews LS. The effect of biopsy-hole shape and size on bone strength. J Bone Joint Surg. 1977;59(2):213–7.

    Article  CAS  PubMed  Google Scholar 

  50. Bickles J, Jelinek JS, Shmookler BM, Neff RS, Malawer MM. Biopsy of musculoskeletal tumors: current concepts. Clin Orthop Relat Res. 1999;368:212–9.

    Google Scholar 

  51. Huang P-Y, Wu P-K, Chen C-F, Lee F-T, Wu H-T, Liu C-L, et al. Osteomyelitis of the femur mimicking bone tumors: a review of 10 cases. World J Surg Oncol. 2013;11:283.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Davido N, Rigolet A, Kerner S, Gruffaz F, Boucher Y. Case of Ewing’s sarcoma misdiagnosed as a periapical lesion of maxillary incisor. J Endod. 2011;37(2):259–64.

    Article  PubMed  Google Scholar 

  53. Gould CF, Ly JQ, Lattin GE, Beall DP, Sutcliffe JB. Bone tumor mimics: avoiding misdiagnosis. Curr Probl Diagn Radiol. 2007;36(3):124–41.

    Article  PubMed  Google Scholar 

  54. Tow BP, Tan MH. Delayed diagnosis of Ewing’s sarcoma of the right humerus initially treated as chronic osteomyelitis: a case report. Journal of Orthopaedic Surgery. 2005;13(1).

    Google Scholar 

  55. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res. 1980;153:106–20.

    Google Scholar 

  56. National Comprehensive Cancer N. NCCN Clinical Practice Guidelines in Oncology-Bone Cancer, 2012. 2013. https://www.nccn.org/professionals/physician_gls/f_guidelines.asp.

  57. Landier W, Knight K, Wong FL, Lee J, Thomas O, Kim H, et al. Ototoxicity in children with high-risk neuroblastoma: prevalence, risk factors, and concordance of grading scales –a report from the children’s oncology group. Journal of Clinical Oncology. 2014:JCO. 2013.51. 38.

    Google Scholar 

  58. Longhi A, Macchiagodena M, Vitali G, Bacci G. Fertility in male patients treated with neoadjuvant chemotherapy for OSA. J Pediatr Hematol Oncol. 2003;25(4):292–6.

    Article  PubMed  Google Scholar 

  59. Isakoff MS, Stefan S, Bielack BM. Osteosarcoma: current treatment and a collaborative pathway to success. J Clin Oncol. 2015;33:3029–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Nagarajan R, Neglia JP, Clohisy DR, Robison LL. Limb salvage and amputation in survivors of pediatric lower-extremity bone tumors: what are the long-term implications? J Clin Oncol. 2002;20(22):4493–501.

    Article  PubMed  Google Scholar 

  61. Onikul E, Fletcher BD, Parham DM, Chen G. Accuracy of MR imaging for estimating intraosseous extent of OSA. AJR Am J Roentgenol. 1996;167(5):1211–5.

    Article  CAS  PubMed  Google Scholar 

  62. Van Trommel MF, Kroon HM, Bloem JL, Hogendoorn PCW, Taminiau AHM. MR imaging based strategies in limb salvage surgery for OSA of the distal femur. Skeletal Radiol. 1997;26(11):636–41.

    Article  CAS  PubMed  Google Scholar 

  63. Picci P, Sangiorgi L, Rougraff BT, Neff JR, Casadei R, Campanacci M. Relationship of chemotherapy-induced necrosis and surgical margins to local recurrence in OSA. J Clin Oncol. 1994;12(12):2699–705.

    CAS  PubMed  Google Scholar 

  64. Gouin F, Heymann M-F. Margins and bone tumors–what are we talking about? Bone Cancer: Prim Bone Cancers Bone Metastases. 2014;287.

    Google Scholar 

  65. Reddy KA, Wafa H, Gaston CL, Grimer RJ, Abudu AT, Jeys LM, et al. Does amputation offer any survival benefit over limb salvage in OSA patients with poor chemonecrosis and close margins? Bone Joint J. 2015;97(1):115–20.

    Article  PubMed  Google Scholar 

  66. Tsuchiya H, Wan SL, Sakayama K, Yamamoto N, Nishida H, Tomita K. Reconstruction using an autograft containing tumour treated by liquid nitrogen. J Bone Joint Surg. 2005;87(2):218–25.

    Article  CAS  Google Scholar 

  67. Jeon D-G, Kim MS, Cho WH, Song WS, Lee S-Y. Pasteurized autograft–prosthesis composite for distal femoral OSA. J Orthop Sci. 2007;12(6):542–9.

    Article  CAS  PubMed  Google Scholar 

  68. Sys G, Uyttendaele D, Poffyn B, Verdonk R, Verstraete K. Extracorporeally irradiated autografts in pelvic reconstruction after malignant tumour resection. Int Orthop. 2002;26(3):174–8.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Masquelet AC, Fitoussi F, Begue T, Muller GP. Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet. 2000;45(3):346–53.

    CAS  PubMed  Google Scholar 

  70. Virkus WV, Henshaw RM, Miller B, Girelis S. Use of allografts and segmental prostheses for reconstruction of segmental bone defects. In: Operative techniques in orthopaedic surgery. Lippincott Williams and Wilkins; Philadelphia, PA. 2010.

    Google Scholar 

  71. Aponte-Tinao L, Farfalli GL, Ritacco LE, Ayerza MA, Muscolo DL. Intercalary femur allografts are an acceptable alternative after tumor resection. Clin Orthop Relat Res. 2012;470(3):728–34.

    Article  PubMed  Google Scholar 

  72. Miller BJ, Virkus WW. Intercalary allograft reconstructions using a compressible intramedullary nail: a preliminary report. Clin Orthop Relat Res. 2010;468(9):2507–13.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Ramseier LE, Malinin TI, Temple HT, Mnaymneh WA, Exner GU. Allograft reconstruction for bone sarcoma of the tibia in the growing child. J Bone Joint Surg. 2006;88(1):95–9.

    Article  CAS  Google Scholar 

  74. Manfrini M, Gasbarrini A, Malaguti C, Ceruso M, Innocenti M, Bini S, et al. Intraepiphyseal resection of the proximal tibia and its impact on lower limb growth. Clin Orthop Relat Res. 1999;358:111–9.

    Article  Google Scholar 

  75. Muscolo DL, Ayerza MA, Aponte-Tinao LA, Ranalletta M. Partial epiphyseal preservation and intercalary allograft reconstruction in high-grade metaphyseal OSA of the knee. J Bone Joint Surg. 2004;86(12):2686–93.

    Article  PubMed  Google Scholar 

  76. Tsuchiya H, Abdel-Wanis ME, Sakurakichi K, Yamashiro T, Tomita K. OSA around the knee Intraepiphyseal excision and biological reconstruction with distraction osteogenesis. J Bone Joint Surg. 2002;84(8):1162–6.

    Article  CAS  Google Scholar 

  77. Wolf RE, Scarborough MT, Enneking WF. Long term followup of patients with autogenous resection arthrodesis of the knee. Clin Orthop Relat Res. 1999;358:36–40.

    Article  Google Scholar 

  78. Chandrasekar CR et al. Modular endoprosthetic replacement for tumours of the proximal femur. J Bone Joint Surg. 2009;91:108–12.

    Article  CAS  Google Scholar 

  79. Kinkel S, Lehner B, Kleinhans JA, Jakubowitz E, Ewerbeck V, Heisel C. Medium to long-term results after reconstruction of bone defects at the knee with tumour endoprostheses. J Surg Oncol. 2010;101:166–9.

    CAS  PubMed  Google Scholar 

  80. Nystrom LM, Morcuende JA. Expanding endoprosthesis for pediatric musculoskeletal malignancy: current concepts and results. Iowa Orthop J. 2010;30:141.

    PubMed  PubMed Central  Google Scholar 

  81. Picardo NE, Blunn GW, Shekkeris AS, Meswania J, Aston WJ, Pollock RC, et al. The medium-term results of the Stanmore non-invasive extendible endoprosthesis in the treatment of paediatric bone tumours. J Bone Joint Surg. 2012;94(3):425–30.

    Article  CAS  Google Scholar 

  82. Mavrogenis AF, Papagelopoulos PJ. Expandable prostheses for the leg in children. Orthopedics. 2012;35(3):173–5.

    Article  PubMed  Google Scholar 

  83. Grimer RJ, Carter SR, Tillman RM, Sneath RS, Walker PS, Unwin PS, et al. Endoprosthetic replacement of the proximal tibia. J Bone Joint Surg. 1999;81(3):488–94.

    Article  CAS  Google Scholar 

  84. van de Sande MAJ, Vochteloo AJH, Dijkstra PDS, Taminiau AHM. Van Nes-Borggreve rotationplasty of the knee. Eur Surg Orthop Traumatol EFORT Textbook. 2014;(1):4135–47.

    Google Scholar 

  85. So NF, Andrews KL, Anderson K, Gozola MA, Shives TC, Rose PS, et al. Prosthetic fitting after rotationplasty of the knee. Am J Phys Med Rehabil. 2014;93(4):328–34.

    Article  PubMed  Google Scholar 

  86. Hillmann A, Hoffmann C, Gosheger G, Krakau H, Winkelmann W. Malignant tumor of the distal part of the femur or the proximal part of the Tibia: endoprosthetic replacement or rotationplasty. Functional outcome and quality-of-life measurements*. J Bone Joint Surg. 1999;81(4):462–8.

    Article  CAS  PubMed  Google Scholar 

  87. Heare T, Hensley MA, Dell’Orfano S. Bone tumors: OSA and Ewing’s sarcoma. Curr Opin Pediatr. 2009;21(3):365–72.

    Article  PubMed  Google Scholar 

  88. Bernthal NM, Monument MJ, Randall RL, Jones KB. Rotationplasty: beauty is in the eye of the beholder. Oper Tech Orthop. 2014;24(2):103–10.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Petri M, Omar M, Horstmann H, Brand S, Krettek C. Eighteen-year follow-up after rotationplasty for a grade IIIC open fracture of the distal femur. Arch Orthop Trauma Surg. 2013;133(3):351–5.

    Article  CAS  PubMed  Google Scholar 

  90. Grimer RJ, Carter SR, Tillman RM, Abudu S, Jeys L. Osa with poor necrosis and close margins–amputation or limb salvage? J Bone Joint Surg Br. 2012;94(SUPP XIV):45.

    Google Scholar 

  91. Bergin PF, Noveau JB, Jelinek JS, Henshaw RM. Aseptic loosening rates in distal femoral endoprostheses: does stem size matter? Clin Orthop Relat Res®. 2012;470(3):743–50.

    Google Scholar 

  92. Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res. 1993;286:241–6.

    Google Scholar 

  93. Malevez C, Dujardin T, Glorieux V, Swennen G, Schutyser F, Van Cleynenbreugel J. Bone distraction osteogenesis. Revue belge de medecine dentaire. 2001;57(2):137–49.

    Google Scholar 

  94. Tsuchiya H, Tomita K, Minematsu K, Mori Y, Asada N, Kitano S. Limb salvage using distraction osteogenesis a classification of the technique. J Bone Joint Surg Br. 1997;79(3):403–11.

    Google Scholar 

  95. Hanlon MJ, Krajbick IJ. Rotationplasty in skeletally immature patients: long term follow-up results. Clin Orthop Relat Res. 1999; 385.

    Google Scholar 

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Graydon, A.J., Hanlon, M.M., Bodian, C.E. (2017). Evidence-Based Treatment for Malignant Paediatric Bone Tumours. In: Alshryda, S., Huntley, J., Banaszkiewicz, P. (eds) Paediatric Orthopaedics. Springer, Cham. https://doi.org/10.1007/978-3-319-41142-2_44

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