"Extremity bone and soft tissue sarcoma are a rare type of cancer with treatment modalities to include chemotherapy and radiation and surgical procedures. Surgery can be limb salvage or limb amputation. Patients of extremity bone and soft tissue sarcomas may experience physical and psychosocial effects due to sarcoma treatments impacting physical performance, quality of life, and social support. Therefore, this study sought to evaluate the complications of extremity bone and soft tissue sarcoma in patients following limb salvage and amputation surgeries."--Leaf ii.

Bone and soft tissue sarcomas represent only about 2% of all malignancies; however, their treatment – with the goal of curing the patient while preserving the functionality of the affected body part – can, unlike other malignancies, only be successful with therapy concepts devised by interdisciplinary teams. This volume provides an extensive up-to-date overview of the specific diagnostics and current treatment standards of these rare entities, presenting the various limb-sparing modalities for patients with bone and soft tissue sarcomas with special regard to innovative reconstructive options. The evaluation of quality of life based on validated scores and the individual methods of coping with the illness through creative artistic projects are also acknowledged and integrated in the whole concept.

This book reflects the experience of the Rizzoli Orthopedic Institute during more than 100 years of treatment of musculoskeletal tumor and tumorlike lesions. It presents a wide range of lesions from a multidisciplinary perspective, highlighting pertinent clinical, radiological, and histological correlations. Treatment is briefly reported for each entity. In addition, the more recent biomolecular findings of use for diagnosis, prognosis, and treatment are carefully analyzed. The Rizzoli case archive spans more than a century, the first treated case dating back to 28 September 1900, and contains the original material – clinical charts, imaging, paraffin blocks, and histological slides – of more than 40,000 cases, including about 29,000 bone lesions and 11,000 soft tissue lesions. This book reports the most relevant entities and reflects the improvements in knowledge of musculoskeletal tumors as presented during the yearly international course held at the Rizzoli Institute.​

Management of Soft Tissue Sarcoma, 2nd Edition provides the most comprehensive analysis of demographics and natural history currently available for these lesions, based on the authors’ experience with over 10,000 patients. Sections regarding radiation therapy not found in the previous text have been expanded, as have updates on molecular characteristics of sarcomas and chemotherapy studies published since the prior edition. Clinical and molecular diagnoses are addressed, and tumor histopathology is employed as the basis of treatment recommendations including surgery, radiation and systemic therapy. This is the first book to provide specific chemotherapy opinions for every sarcoma subtype. Written by four world-renowned experts, this book gives a practical, up-to-date approach to managing the many subtypes of adult soft tissue sarcoma. Reviews from the first edition: “This is an impressive book. Written by a surgeon, a pathologist and an oncologist, the book draws heavily on the Memorial Sloan-Kettering Cancer Center soft tissue sarcoma (STS) database. ... it is a book that should be in the library of any sarcoma unit and will appeal to the sub-specialist in Orthopaedic Oncology.” (Robert U. Ashford, European Journal of Orthopaedic Surgery & Traumatology, Vol. 24, 2014) “The book is laid out in 27 chapters, with an impressive inclusion of a wide array of sarcoma histology. One of the real strengths of the book is the quality and number of images, figures, tables, and graphs. ... The overall outline of the text is well done. ... This book is a unique and important addition to the sarcoma literature. ... this edtion should find itself on every medical oncologist’s bookshelf ... .” (Larry C. Daugherty and Sanjay P. Bagaria, Journal of Radiation Oncology, Vol. 3, 2014)

Introduction of new diagnostic methods including various imaging techniques in the field of orthopaedic surgery has enabled us to make early and precise diagnoses of musculoskeletal tumors. In addition, recent progress in the chemotherapy and radiotherapy of malignant tumors has raised the five-year survival rate remarkably, although complete recovery from these treatments alone cannot be expected as yet. These medical advances naturally stimulate the search for ways of limb salvage even in malignant musculoskeletal oncology. To this pur pose, not only oncologists, but orthopaedic surgeons, radiologists, engineers, and biomaterials scientists should work together to design suitable surgical procedures and prostheses using autograft, allograft and biomaterials. The First International Workshop on the Design and Application of Tumor Prostheses for Bone and Joint Reconstruction was held in 1981 in Rochester, Minnesota. Participants were of an interdisciplinary nature in order to establish a basis for cooperative efforts, which have subsequently spread throughout the world. Since then, biennial inter national symposia have been held successively in Vienna, Florida, and Kyoto. Previous gatherings of this prestigious series were open only to a small number of experts.

Steven A. Rosenberg, MD In the past two decades significant progress has quality of life. The use of local radiation therapy has occurred, in the management of patients with mus- had a profound impact on the ability to achieve local loskeletal cancers, that has improved both the survival control. Cooperation between surgeons and radiation and the quality of life of afflicted patients. Changes in therapists often results in the tailoring of surgical p- the management of these patients have mirrored cedures to maximize the combined application of these trends in the entire field of oncology. two effective treatment modalities. Although impact on The most significant change has been improvement overall survival has not been demonstrated due to the in the surgical techniques for the resection of musculo- addition of radiation therapy, important advances in skeletal cancers based on a detailed understanding of improving the quality of life of patients receiving this the anatomic features of each particular tumor site, as combined-modality treatment have been evident. well as an appreciation of the natural biology that affects A third change impacting on the survival of patients the local spread of these tumors. The current volume of with musculoskeletal cancers has been the aggressive Musculoskeletal Cancer Surgery: Treatment of Sarcomas and resection of metastatic deposits.

This retrospective cohort study explored the impact of soft tissue reconstruction on function (impairments, activities, participation) and health status outcomes at 12-24 months following limb salvage surgery for adult patients with extremity soft tissue sarcoma (ESTS). Eligible patients (n=247) were identified from a prospectively maintained database. The effects of flap reconstruction on post-operative function and health status were analyzed using three methods (regression, matching, propensity scores) for handling selection bias in observational research. ESTS patients receiving flap reconstruction (n=56) had more postoperative impairments (p=0.001) and activity limitations (p=0.007) than patients treated with primary closure (n=191). However, flap reconstruction was not significantly associated with post-operative function and health status after controlling for confounders using regression, matching, or propensity scores. The main conclusion was that while ESTS patients receiving flaps had several risk factors for worse outcomes, soft tissue reconstruction did not detrimentally affect function or health status at 1-2 years following limb salvage surgery.

Intensity-modulated radiation therapy (IMRT), one of the most important developments in radiation oncology in the past 25 years, involves technology to deliver radiation to tumors in the right location, quantity and time. Unavoidable irradiation of surrounding normal tissues is distributed so as to preserve their function. The achievements and future directions in the field are grouped in the three sections of the book, each suitable for supporting a teaching course. Part 1 contains topical reviews of the basic principles of IMRT, part 2 describes advanced techniques such as image-guided and biologically based approaches, and part 3 focuses on investigation of IMRT to improve outcome at various cancer sites.

The must-have book for candidates preparing for the oral component of the FRCS (Tr and Orth).