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Biomedical subjects

M Campanacci

Publications and source records attributed to M Campanacci.

At least 109 records · Page 6Linked to original sources
PubMed1986

Neoadjuvant chemotherapy for high grade osteosarcoma of the extremities: is a good response to preoperative treatment an indication to reduce postoperative chemotherapy?

Sixty-five patients with high grade central localized osteosarcoma of the extremities were treated according to a neoadjuvant chemotherapy schedule that was comprised of two methotrexate (MTX) cycles (high or moderate dosage) i.v. followed by cisplatinum (CDP) (continuous i.a. infusion for 24 hours). Thirty-four "good" responders (necrosis greater than 90%) were divide in two groups for post-operative treatment. The first group was treated for a short period (4 weeks) with i.v. MTX-CDP; the second group was treated for a longer period (24 weeks) with i.v. MTX-CDP and also adriamycin. Patients in the second group had far better results than the patients in the first group (19/19 vs. 5/15 continuously disease-free patients). Our results following this protocol indicate that even if patients are "good" responders to this neoadjuvant chemotherapy they should not undergo a shortened post-operative treatment, and the protocol should include adriamycin.

Adolescent↗
PubMed1986

Subtotal and total femoral resection: an alternative to total femoral prosthetic replacement.

Two cases of chondrosarcoma involving the proximal femur and the soft tissues are reported. Both patients underwent subtotal femoral resection and quadriceps excision followed by reconstruction with a special prosthesis and arthrodesis of the knee. The tibial stem of the prosthesis was fixed with cement. The advantages of this method are discussed and compared with the use of total femoral prostheses.

Arthrodesis↗
PubMed1986

Unicameral and aneurysmal bone cysts.

One hundred and seventy-eight cases of unicameral bone cysts (UBC) treated with curettage and bone grafting were compared to 141 cases treated with cortisone injections. The end results were comparable in the two groups. Local recurrence risk factors in the surgical group were active cyst and previous operations. In the other group they were multilocation of the cyst, active cyst, and size of cyst. A new radiographic classification of aneurysmal bone cyst (ABC) is proposed in a report of 198 cases of ABC. The treatment of choice in ABC is surgical and the type (curettage, curettage plus phenole or cryosurgery, resection or hemiresection) is selected on the basis of the radiographic aspect and the rate of growth of the cyst. Radiotherapy is only indicated in inoperable ABC cases.

Adolescent↗
PubMed1985

Histologic evaluation of necrosis in osteosarcoma induced by chemotherapy. Regional mapping of viable and nonviable tumor.

The predominant sites of viable and nonviable tumor were determined in the primary lesions of 50 patients with osteosarcoma after initial treatment with preoperative chemotherapy. The degree of tumor destruction was classified as good, fair, and poor and a map of the sites revealing viable and nonviable tumor was constructed. The study revealed several preferential sites where viable tumor was likely to persist: soft tissues, cortex, subcortex, ligaments, and areas in contact with cartilage (growth plate and/or articular cartilage). Localized areas of hemorrhage and necrosis, designated "lacunae," were noted within the tumor. They were frequently surrounded by bundles of viable tumor and appeared to correlate with open surgical biopsies. Factors responsible for this phenomenon and the persistence of viable tumor are discussed. The findings have important implications in the design of surgical treatment and in the use of needle biopsies to determine the effects of preoperative treatment.

Adolescent↗
PubMed1985

Staging, therapy and prognosis of primary non-Hodgkin's lymphoma of bone and a comparison of results with localized Ewing's sarcoma: ten years experience at the Istituto Ortopedico Rizzoli.

Thirty consecutive cases of localized primary non-Hodgkin's lymphoma of bone (PNHLB) were treated in a 10-year period at the Istituto Ortopedico Rizzoli with localized radiation (4 cases) and localized radiation and adjuvant chemotherapy (26 cases). The doses of radiation varied from 3000-4500 rad. A variety of staging procedures evolving with new diagnostic techniques over the 10 years were performed. Adjuvant chemotherapy comprised two different regimens of vincristine, adriamycin and cyclophosphamide. Twenty-four of the 26 patients (92%) have been free of disease with a median follow-up of 75.5 months (18-144 months). Two patients developed meningeal involvement and one patient, treated with radiation therapy only, developed a local recurrence. The results are compared to the management of 68 Ewing's sarcoma patients treated during the same period. Here, higher doses of localized radiation therapy (approximately 5000 rad) and similar adjuvant chemotherapy were administered. The survival was 32% (22/68) with a higher incidence of local recurrence (21%). These data indicate that PNHLB should be considered a separate entity from Ewing's sarcoma and can be treated successfully with lower doses of radiation to the primary tumor and adjuvant chemotherapy. The observations are also compared to a variety of other biological characteristics of Ewing's sarcoma. Since only two patients developed meningeal relapse, our experience does not permit a firm recommendation for routine prophylactic treatment of the central nervous system in PNHLB.

Adolescent↗
PubMed1985

Malignant fibrous histiocytoma of soft tissue. An analysis of 78 cases located and deeply seated in the extremities.

Seventy-eight cases of malignant fibrous histiocytoma (MFH) of soft tissues are reported. All tumors were deeply located in the extremities. An analysis is presented with regard to sex, age, site, macro- and microscopic features. The staging was assessed according to Enneking's classification (IB, one case; IIA, 25 cases; IIB, 42 cases; III, 10 cases). The recurrence rate after surgical treatment was high (37.5%) with significant differences after inadequate surgery (70%), wide excision (38%), or amputation (0%). Adjunctive radiotherapy rarely was effective in preventing local recurrence. The overall 5-year survival rate was 36%. The prognosis was worse in (1) tumors larger than 5 cm in diameter, (2) tumors that recurred early (less than 1 year) after surgery, and (3) tumors that had inadequate surgical treatment (intralesional or marginal excision).

Actuarial Analysis↗
PubMed1985

Localized Ewing's sarcoma of bone: ten years' experience at the Istituto Ortopedico Rizzoli in 124 cases treated with multimodal therapy.

The results obtained in the treatment by multimodal therapy (surgery, radiation therapy and chemotherapy) of 124 cases of Ewing's sarcoma are presented. At a medium follow-up of 65 months 48% of the patients are disease-free. One patient died of leukemia and two patients developed an irradiation-induced sarcoma. Analysing the data, three factors seem to be correlated to prognosis: location of the initial lesion outside the pelvis and sacrum, a four-drug chemotherapy protocol and the use of surgery in the treatment of the initial lesion seem to give better results.

Adolescent↗
PubMed1985

Autogenous patella as replacement for a resected femoral or tibial condyle. A report on 19 cases.

The size and shape of the patella make it suitable for the partial replacement of a femoral or tibial condyle resected for tumour, or destroyed by trauma. It can provide a good articular surface and may give satisfactory knee function. Nineteen cases of patellar grafts are presented, with follow-up from two to nine years. Good consolidation of the graft and fair stability of the joint were obtained; the range of movement was 90 degrees or more in 79% of cases. In contrast with an allograft of a femoral or tibial condyle, the technique described does not need an allograft bank, has a lower risk of infection, and allows better and quicker consolidation and revascularisation of the grafts, as well as a better range of movement at the knee, probably because of the lack of fibrosis from immunological reaction. Merle d'Aubigné's technique, using a patellar graft with a vascular muscle pedicle, is useful only for some cases, requires a longer period of immobilisation and weakens the extensor apparatus. Our series shows that consolidation and revascularisation of a patellar graft can occur in the absence of a pedicle.

Adolescent↗
PubMed1985

Adjuvant chemotherapy for malignant fibrous histiocytoma in the femur and tibia.

Between 1974 and 1982, twelve patients with malignant fibrous histiocytoma of the femur and tibia were treated by excision and adjuvant chemotherapy. During the same time-period, eighteen patients were treated by excision alone. The disease-free survival rate among the former was 59 per cent (seven of twelve). There was only one survival in the latter group.

Adolescent↗
PubMed1985

The Kotz modular prosthesis in massive osteo-articular resections for bone tumours: preliminary results in 27 cases.

The authors report 27 cases in which neoplasms of the proximal or distal femur were treated by resection and replacement with a Kotz modular prosthesis. In 25 cases this was not cemented but in the other 2 cases cement had to be used. After describing the prosthesis and presenting the case material, the authors discuss the advantages and limitations of this surgical technique and compare the results obtained with those reported in the literature.

Adolescent↗
PubMed1985

Aneurysmal cysts of long bones.

The authors reviewed 121 cases of aneurysmal cysts of the long bones treated at the Tumour Centre of the Rizzoli Institute of Orthopaedics of which 103 had been followed up for more than one year. A classification is proposed based on 5 morphological groups and 3 grades of aggression. All except 4 of these lesions were treated by curettage or resection (2 were treated by radiotherapy alone, and 2 only had biopsies). The overall results showed a recurrence rate of 13%, none of which were in the inactive group. There was no prognostically significant difference in the recurrence rate between the active and aggressive groups. In the morphological groups there were significant prognostic differences. The authors therefore advise a programme of treatment based on an assessment of the morphological type and aggressiveness of these tumours.

Adolescent↗
PubMed1985

Aneurysmal bone cyst of the spine.

The cases of twenty-two patients with an aneurysmal bone cyst of the spine above the sacrum were analyzed with regard to sex, age, site, symptoms, and radiographic findings. Four patients had extension of the lesion to the adjacent vertebra or rib, and twelve patients had neurological deficits. The primary treatment was either radiotherapy or surgery alone, or surgery and radiotherapy combined. No recurrences were found in patients who were treated with surgery alone or with surgery and radiotherapy, while three of the six patients who were treated with radiotherapy had a local recurrence, two of which were fatal. The patients with neurological deficits recovered after healing of the cyst.

Adolescent↗
PubMed1985

Chondroblastoma. A review of seventy cases.

We reviewed the cases of seventy patients with chondroblastoma who were treated at the Istituto Ortopedico Rizzoli between 1949 and 1983 and found that the proximal end of the humerus was the most common location (eighteen), with the proximal end of the femur (fifteen), distal end of the femur (fifteen), and proximal end of the tibia (twelve) being the other frequently involved sites. Sixty-three of the patients were between eleven and thirty years old. Fifty-eight patients sought medical attention because of an aching pain, usually referred to the adjacent joint. Fifty patients were followed for two years or longer after treatment. Seven patients had a local recurrence: four were successfully treated with a repeat curettage and one, by two subsequent marginal excisions; one was advised to have a repeat curettage; and the seventh was advised to have a resection and arthrodesis of the knee. The final functional results were considered to be excellent in forty-seven of the fifty patients who were followed for two years or more.

Adolescent↗
PubMed1985

Extra-articular resection of the shoulder (Tikhoff-Linberg).

The authors have reviewed 21 cases of extra-articular resection of the shoulder, using the Tikhoff-Linberg technique, carried out at the Tumour Centre of the Rizzoli Institute. The effectiveness of this method has been evaluated both oncologically (by a study of the resected specimens) and functionally. The possible complications are considered. The authors describe a modification of the technique for tumours of the proximal humerus in which only part of the scapula is removed.

Adolescent↗
PubMed1985

Phenol as an adjuvant in the control of local recurrence of benign neoplasms of bone treated by curettage.

Throughout the present century phenol has been used to "sterilise" the edges of cavities left in bone after the clearance of benign tumours in order to reduce the risk of local recurrence. The results have been analysed of 165 benign bone tumours capable of local recurrence (aneurysmal bone cyst, chondroblastoma, giant cell tumour) treated with and without the use of phenol. The overall recurrence rate was 41% in 98 cases treated by simple curettage and 7% in 27 cases treated by curettage followed by the application of phenol.

Adolescent↗
PubMed1985

[Resection with preservation of the lower limb in chondrosarcoma of the pelvis].

Twenty-seven chondrosarcomata of the pelvis were treated by local resection with preservation of the limb. Twenty-two were grade I or II, and 5 were grade III or IV. Attention is drawn to the importance of tomodensitometry in assessing the extent of the tumor before operation. An en bloc resection was well wide of the tumour in 16 cases, close to the tumour in 10 cases and involved the tumour in one case. Post-operative complications were varied. There were 6 nerve paralyses after iliac resection, 3 cases of sepsis after resection of the anterior part of the pelvic ring, and 3 cases of sepsis and 2 vascular complications after peri-acetabular resections. The average follow-up was 5 years. Three had metastases and three had local recurrences, one of whom died later from pulmonary metastases. No local recuRrence was seen in cases with wide resection. The functional results were satisfactory in 6 out of 7 partial resections of the ilium and in 4 out of 5 resections of the anterior part of the pelvic ring. They were only fair after peri-acetabular resections and complete resections of the ilium. After peri-acetabular resections, the results were about the same after ilio-femoral arthrodesis or Girdlestone operations. It is not appropriate to reconstruct the pelvic ring after resection limited to the anterior part of the pelvis but it is indicated after resections of the whole of the ilium, particularly in children to avoid shortening of the limb with pelvic shift.

Adult↗
PubMed1984

Malignant fibrous histiocytoma of bone. The experience at the Rizzoli Institute: report of 90 cases.

Ninety cases of malignant fibrous histiocytoma (MFH) of bone are reported. An analysis is presented with regard to sex, age, site, symptoms, radiography, macroscopic, and microscopic features. The staging was assessed according to the following classification: I B: 3 cases; II A: 11 cases; II B: 66 cases; III: 10 cases. Among nonmetastatic patients, 68 had surgical treatment (adequate, 46; inadequate, 22); 8 had radiotherapy, and 3 refused any treatment. Among surgically treated patients, 20 had adjuvant chemotherapy, also. Follow-up information was obtained in all cases. Overall survival rates were 34% at 5 years, and 28% at 10 years. Surgery alone did not appear to be successful (5-year survival, 28%). Adjuvant chemotherapy improved the survival rate only in patients who underwent adequate surgery (5-year survival, 57%). The recurrence rate after surgical treatment was high (31%) with significant differences after inadequate (64%), wide (19%), or radical (6.5%) surgical treatment. Adjuvant chemotherapy was ineffective in preventing local recurrence. Radiation therapy effected a clinical cure in three cases; the authors believe that radiation therapy has to be used only in inoperable tumors.

Adolescent↗