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Objective:To explore the construction and application methods of multicenter bone tumor-specific database.Methods:Experts from multiple centers including Shanghai General Hospital, Shanghai Changzheng Hospital, Zhongshan Hospital, Shanghai Sixth People's Hospital, Ruijin Hospital, Fudan University Shanghai Cancer Center and Shanghai Ninth People's Hospital established a standard dataset for bone tumors through research and discussion. Clinical data will be automatically collected and standardized according to standard fields. A database will be built and a users' interface will be developed to ensure secure data storage, while providing services such as exporting raw data, visualizing statistical analysis, establishing clinical queue research projects, et al. Finally, the bone tumor database will be shared by integrating with the Shenkang's Big Data Platform to achieve multi-center data integration.Results:A standard data set for bone tumors containing 603 fields has been established and published. An automated data collection system for bone tumors has been established, including complete data collection, data collation and visualization functions. The data categories include modules such as patients' electronic case information, laboratory information on blood routine, biochemistry and tumor markers, imaging information, surgery information, pathology information and radiotherapy records. Personal information such as patients' names and ID numbers are desensitized and encrypted and can be exported for further research. From 2015 to 2023, the total number of bone tumor cases collected in the database was 10,789. From 2015 to 2019, 112 cases of the osteosarcoma cohort were retrospectively analyzed for admission, with a statistical 5-year survival rate of 68%.Conclusion:A regional bone tumor specialty big data network and data sharing platform has been established, along with data sharing mechanisms and standards including data standards, security standards, and quality evaluation standards. This provides data and efficient new solutions for the construction of China's bone tumor database, as well as a research and development platform for standardized diagnosis and treatment of bone tumors and new technologies.
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To report the short-term clinical outcome of three cases of distal tibial osteosarcoma treated with a novel 3D-printed ankle fusion prosthesis for limb preservation. The patients were admitted to the Department of Bone Tumor, Shanghai General Hospital from January 2020 to June 2021, with one male and two female cases, aged 18, 12, and 14 years, respectively, all diagnosed with distal tibial osteosarcoma (Ennecking stage IIb). A new self-designed ankle fusion prosthesis was used to perform osteosarcoma resection and prosthetic reconstruction of the distal tibia. The operation time, blood loss, postoperative American Orthopedic Foot and Ankle Society Score (AOFAS) and ankle range of motion were recorded. All the 3 patients successfully completed the operation and were followed up for 22 months, 18 months and 12 months, respectively. The operation time was 140 min, 110 min and 200 min, and the blood loss was 200 ml, 200 ml and 350 ml, respectively. At the last follow-up, the AOFAS were 86, 90 and 95 points, and the range of motion of ankle flexion and extension were 30°, 15° and 30°. There was no local recurrence or lung metastasis at the last follow-up. The novel 3D-printed ankle fusion prosthesis in the distal tibia is safe and effective for the reconstruction of bone defects after resection of osteosarcoma in the distal tibia, and the early postoperative function is satisfactory.
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Objective To compare the prognostic value of different inflammation-based prognostic scores and Tumor Node Metastasis ( TNM) stage for patients undergoing radical resection of pancreatic cancer with the routine TNM stage in clinical practice.Methods Clinical data of 185 patients with pancreatic cancer who underwent radical surgery were retrospectively analyzed.Based on the inflammation-based prognostic scores ( Glasgow prognostic score ( GPS ) , neutrophil lymphocyte ratio ( NLR ) , platelet lymphocyte ratio ( PLR) , prognostic nutritional index ( PNI ) and prognostic index ( PI ) ) before surgery, univariate and multivariate analyses were used for identifying influential factors on patients′survival.Homogeneity of different scoring systems was compared using likelihood ratio chi-quare test, and linear trend chi-square test, and receiver operating characteristic ( ROC) curve were performed to compare the differentiating ability and single trend of the selected scores with those of routine TNM stage.Results In univariate analysis, preoperative weight loss, serum C-reactive protein, serum albumin, CA19-9, radical surgery, NLR, PLR, GPS, PI, PNI and TNM stage were all significantly associated with patients′overall survival after surgery (P<0.001).In multivariate cox risk model analysis, TNM stage, radical surgery, GPS, NLR, PLR, PI and PNI were independent risk factors for patients′survival after surgery.ROC curve showed that GPS had higher AUC than other scoring systems, but TNM stage had the highest AUC.The homogeneity, differentiating ability and single trend of GPS were higher compared to other inflammation-based prognostic scores, but those of TNM stage were the highest.Conclusions The inflammation-based prognostic scores like GPS, NLR, PLR, PI and PNI were independent prognostic factors for pancreatic caner patients′survival after surgery, and the prognostic value of GPS was superior to that of NLR, PLR, PI and PNI.
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Objective To observe the clinical effect of temozolomide combined with radiotherapy in the treatment of malignant gliomas. Methods A total of 64 patients with pathologically confirmed glioblastoma received radiotherapy combined with chemotherapy in our hospital from January 2008 to January 2014, radiotherapy synchronized with TMZ chemotherapy were used in 39 patients (synchronized group) and radiotherapy sequential with TMZ chemotherapy in 25 patients (sequential group).1 year and 3 year survival rates, response rate and drug safety were compared between the two groups. Results The patients were followed up for 6 months to 3 years, the synchronous group of patients 1 years and 3 years survival rates (74.4%, 38.5%) were higher than the sequential group(64.0%, 28.0%) (P<0.05), objective re-sponse rate of two groups were 64.1%and 44.0%, the difference was statistically significant(P<0.05), gastrointestinal re-action rates of two groups were 23.1% and 20.0%, the difference was not statistically significant (P>0.05). Adverse re-actions were statistically significant (P<0.05). Conclusion The effect of radiotherapy synchronized combined with TMZ chemotherapy is better than radiotherapy sequential with TMZ chemotherapy for glioblastoma, it is still the first choice for the treatment of glioblastoma although the clinical manifestations of toxicity increased than the sequential group.
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Objective To investigate the effect of neuronavigation assisted microscopic transsphenoidal resection of non-invasived pituitary tumor. Methods Retrospective analysis of clinical data of 72 cases of transsphenoidal operation for non-invasived pituitary tumor from January 2012 to January 2014. Results All patients were successfully completed the surgery, total resection in 65 cases, subtotal resection in 4 cases, partial resection in 3 cases, 7 cases in subtotal resection were treated with gamma knife radiotherapy after operation, hyperprolactin were given bromocriptine treatment after surgery. Patients were followed up for 6 months to 3 years, the remission rate was 89.2% in the postoperative headache, visual disorder remission rate 68.6%, endocrine disorders and the remission rate was 57.6%. 5 cases of post-operative cerebrospinal fluid rhinorrhea underwent repair, 8 cases had diabetes insipidus, 1 case of partial resection progressed to suprasellar and parasellar after 1.5 years, underwent craniotomy operation again. Conclusion For non-in-vasived pituitary tumor, microscopic transsphenoidal sugery is safe, convenient, and has no significant difference com-pared with the effect of endoscopic endonasal transsphenoidal approach.