Biomedical subjects

M San-Julian

Publications and source records attributed to M San-Julian.

5 recordsLinked to original sources

PubMed2003

Osteosarcoma over the age of forty.

The European Musculo Skeletal Oncology Society (EMSOS) has carried out a retrospective review of patients over the age of 40 years with osteosarcoma. 481 patients from 12 centres or multicentric groups were included. 42 patients had osteosarcoma arising in Paget's disease, median survival was 9 months. Patients with axial or metastatic tumours also did badly whilst 41 patients with radiation-induced osteosarcoma had a prognosis paralleling conventional osteosarcoma matched for patient age and site of the tumour. 238 patients had high grade non-metastatic osteosarcoma and had a survival of 46% at 5 years. Older patients had less chemotherapy and fared worse. Osteosarcoma in the elderly is a curable condition and warrants intensive treatment with chemotherapy and surgical resection.

Adult↗

PubMed2002

Bone metastases from osteosarcoma.

Bony metastases in patients with osteosarcoma are unusual and normally appear late in the course of the disease. We report our experience with eight such patients, four with solitary and four with multiple metastases. Those with solitary metastases were treated as new tumours with neoadjuvant chemotherapy and surgery. Three remain alive with no evidence of disease at 5, 7 and 8 years follow-up respectively. Histology and response to neoadjuvant chemotherapy was similar in both the primary and metastatic lesions and is a predictive factor of outcome. Those with multiple metastases were treated by palliative measures, and none survived. We conclude that resection of solitary metastases from osteosarcoma after neoadjuvant chemotherapy can be curative.

Adolescent↗

PubMed1998

Fractures of allografts used in limb preserving operations.

One hundred and thirty-seven allografts used since 1986 in limb preserving operations for malignant bone tumours were reviewed. The follow up was longer than two years. There were fourteen fractures (10.2%) in twelve patients at a mean time of 22 months from the operation. Most of them were in the metaphyseal area and were related to perforations of the allograft made for stabilisation with plates, for tendon and ligament reattachment, or any other hole in the allograft. Fractures occurred always after the allograft-host junction was united. Healing was achieved in 7 cases by internal fixation with autologous bone grafting in a mean of 5 months. In cases of multiple fractures of the allograft, the graft was exchanged. We recommend using intramedullary fixation in order to reduce the incidence of allograft fracture, and the use of internal fixation, with intramedullary whenever possible, and autologous bone grafting to achieve consolidation of the fractures.

Adolescent↗

PubMed1998

External fixation in tumour pathology.

An appraisal of the clinical records of patients with malignant bone tumours enabled us to identify 61 whom we have treated by external fixation. There were 38 males and 23 females with ages ranging from 4 to 58 years, the mean being 14 years. The average period of follow-up was 6 years (1-12 years). For the purpose of our analysis the patients were divided into three groups according to whether the fixator was fitted before, during or after tumour resection.

Adolescent↗

PubMedDate not supplied

Indications for epiphyseal preservation in metaphyseal malignant bone tumors of children: relationship between image methods and histological findings.

We compared several image methods in the evaluation of the possible physeal effect in 47 osteosarcomas and 18 Ewing's sarcomas in children. The minimal follow-up was 3 years (range, 3-17). In the histological study, the physis was affected in 53% of the cases. We correlated the histological findings and the findings from the different image methods. There were more false-positive than false-negative results, and in the computed tomography and magnetic resonance imaging (MRI) studies, there were no false negatives. The accuracy of MRI (predictive positive value plus predictive negative value) was the best (90.3%), and it is the technique that we prefer. According to these findings, we can safely preserve the epiphysis in cases of metaphyseal tumors showing no contact between the tumor and the growth plate in the MRI images. If the tumor shows contact with part of the physis, it is also possible to preserve the epiphysis.

Adolescent↗