Diagnoses, treatment, and oncologic outcomes in patients with calcaneal malignances: Case series, systematic literature review, and pooled cohort analysis.
J Surg Oncol
; 122(8): 1731-1746, 2020 Dec.
Article
de En
| MEDLINE
| ID: mdl-32974945
ABSTRACT
BACKGROUND AND OBJECTIVES:
Malignant tumors of the calcaneus are rare but pose a treatment challenge.AIMS:
(1) describe the demographics of calcaneal malignancies in a large cohort; (2) describe survival after amputation versus limb-salvage surgery for high-grade tumors.METHODS:
Study group a "pooled" cohort of patients with primary calcaneal malignancies treated at two cancer centers (1984-2015) and systematic literature review. Kaplan-Meier analyses described survival across treatment and diagnostic groups; proportional hazards modeling assessed mortality after amputation versus limb salvage.RESULTS:
A total of 131 patients (11 treated at our centers and 120 patients from 53 published studies) with a median 36-month follow-up were included. Diagnoses included Ewing sarcoma (41%), osteosarcoma (30%), and chondrosarcoma (17%); 5-year survival rates were 43%, 73% (70%, high grade only), and 84% (60%, high grade only), respectively. Treatment involved amputation in 52%, limb salvage in 27%, and no surgery in 21%. There was no difference in mortality following limb salvage surgery (vs. amputation) for high-grade tumors (HR 0.38; 95% CI 0.14-1.05), after adjusting for Ewing sarcoma diagnosis (HR 5.15; 95% CI 1.55-17.14), metastatic disease at diagnosis (HR 3.88; 95% CI 1.29-11.64), and age (per-year HR 1.04; 95% CI 1.02-1.07).CONCLUSIONS:
Limb salvage is oncologically-feasible for calcaneal malignancies.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Sarcome d'Ewing
/
Tumeurs osseuses
/
Ostéosarcome
/
Chondrosarcome
Type d'étude:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limites:
Adult
/
Child
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
J Surg Oncol
Année:
2020
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique