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Identification of Breast Cancer Patients at Risk for Bone Metastasis – A Case–Control Study

May 10, 2019/in Vol 5 | Issue 2 | May-Aug 2019 /by jbstadmin

Case Report | Volume 5 | Issue 2 | JBST May – August 2019 | Page 15-19| Purnima Thakur, Vishal Verma, Ekta Dogra, Ankur Gupta, Manish Gupta, Vikas Fotedar. DOI: 10.13107/jbst.2019.v05i02.430 Author Purnima Thakur[1], Vishal Verma[2], Ekta Dogra[3], Ankur Gupta[4], Manish Gupta[1], Vikas Fotedar[1] [1]Department of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, [2]Department […]

Quality of Life and Functional Outcome of Patients Treated with Revision Limb Salvage Surgery and Amputation: A Cross-Sectional Study

May 10, 2019/in Vol 5 | Issue 2 | May-Aug 2019 /by jbstadmin

Case Report | Volume 5 | Issue 2 | JBST May – August 2019 | Page 11-14| M S Satish, Srinivasan Vijay, Anand Raja, Surendran Veeraiah. DOI: 10.13107/jbst.2019.v05i02.428 Author M S Satish[1], Srinivasan Vijay[1], Anand Raja[2], Surendran Veeraiah[3] [1]Department of Physiotherapist, Cancer Institute (WIA), Chennai, Tamil Nadu, India, [2]Department of Surgical Oncology, Cancer Institute (WIA), Chennai, […]

Identification of Breast Cancer Patients at Risk for Bone Metastasis – A Case–Control Study

May 10, 2019/in Vol 5 | Issue 2 | May-Aug 2019 /by jbstadmin

Quality of Life and Functional Outcome of Patients Treated with Revision Limb Salvage Surgery and Amputation: A Cross-Sectional Study

May 10, 2019/in Vol 5 | Issue 2 | May-Aug 2019 /by jbstadmin

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Identification of Breast Cancer Patients at Risk for Bone Metastasis – A Case–Control Study

May 10, 2019/in Vol 5 | Issue 2 | May-Aug 2019 /by jbstadmin

Author Purnima Thakur[1], Vishal Verma[2], Ekta Dogra[3], Ankur Gupta[4], Manish Gupta[1], Vikas Fotedar[1]
[1]Department of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India,
[2]Department of Orthopedics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India,
[3]Department of Community Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
[4]Department of Anatomy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.

Address of Correspondence
Dr. Vishal Verma,
Department of Orthopedics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
E-mail: vishhal82@gmail.com

Abstract
Introduction: Prognostic factors for metastatic breast carcinoma are a less studied topic than a prognostic factor for primary breast cancer. Bone is the most frequent site for metastasis in breast cancer patients. Bone metastasis decreases the survival and impacts the quality of life(QoL)in breast cancer patients. Therefore, the study to identify prognostic factors of this specific group of patients appears to be worthy of more detailed study. To the best of our knowledge, this is the first study of its kind in the North Indian population.
Materials and Methods: A retrospective case–control study was conducted at a tertiary cancer centerin Northern India between January 2011 and December 2015. All patients’ clinical and demographic data were obtained from the medical record of the institute. The incidence and distribution of bone metastases from breast cancer were evaluated, and the correlation between diverse clinical-pathological parameters and bone metastases were analyzed in this study.
Results: A total of 363 patients were recruited, including 94 cases with bone metastases and 269 controls without bone metastases at presentation. Positive axillary lymph node status, higher stage tumors, HER2 neu-negative disease, and histological subtypes of tumor were found significant prognostic factors in univariate analysis associated with higher rates of bone metastasis. Luminal A(estrogen receptor-positive [ER+], progesterone receptor-positive [PR+], HER2–ve, Grade 1,2), and HER 2 enriched (ER –ve, PR–ve, and HER 2+) molecular subtypes are associated with increased risk of bone metastasis. None of the risk factors studied were significantly associated with bonemetastasis in binary logistic regression analysis.
Conclusion: Identification of breast cancer patients at risk for bone metastasis may aid in the prevention, prediction, detection, and early treatment of these lesions, thus providing improved survival and better QoL.
Keywords: Bone metastasis, risk factors, breast cancer.

References
1. Liede A, Jerzak KJ, Hernandez RK, Wade SW, Sun P, Narod SA, et al. The incidence of bone metastasis after early-stage breast cancer in Canada. Breast Cancer Res Treat 2016;156:587-95.
2. Coleman RE. Metastatic bone disease: Clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 2001;27:165-76.
3. Koizumi M, Yoshimoto M, Kasumi F, Iwase T, Ogata E. Post-operative breast cancer patients diagnosed with skeletal metastasis without bone pain had fewer skeletal-related events and deaths than those with bone pain. BMC Cancer 2010;10:423.
4. Cramarossa G, Chow E, Zhang L, Bedard G, Zeng L, Sahgal A, et al. Predictive factors for overall quality of life in patients with advanced cancer. Support Care Cancer 2013;21:1709-16.
5. Lee SJ, Park S, Ahn HK, Yi JH, Cho EY, Sun JM, et al. Implications of bone-only metastases in breast cancer: Favorable preference with excellent outcomes of hormone receptor positive breast cancer. Cancer Res Treat 2011;43:89-95.
6. Ahn SG, Lee HM, Cho SH, Lee SA, Hwang SH, Jeong J, et al. Prognostic factors for patients with bone-only metastasis in breast cancer. Yonsei Med J 2013;54:1168-77.
7. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D, et al. Global cancer statistics. CA Cancer J Clin 2011;61:69-90.
8. Parkin DM. Cancer base No. 7. In: Cancer Incidence in Five Continents. Vol. 1-8. Lyon: IARC Press; 2005.
9. Brockton NT, Gill SJ, Laborge SL, Paterson AH, Cook LS, Vogel HJ, et al. The breast cancer to bone (B2B) metastases research program: A multi-disciplinary investigation of bone metastases from breast cancer. BMC Cancer 2015;15:512.
10. Pulido C, Vendrell I, Ferreira AR, Casimiro S, Mansinho A, Alho I, et al. Bone metastasis risk factors in breast cancer. Ecancermedicalscience2017;11:715.
11. Chen WZ, Shen JF, Zhou Y, Chen XY, Liu JM, Liu ZL, et al. Clinical characteristics and risk factors for developing bone metastases in patients with breast cancer. Sci Rep 2017;7:11325.
12. Colleoni M, O’Neill A, Goldhirsch A, Gelber RD, Bonetti M, Thürlimann B, et al. Identifying breast cancer patients at high risk for bone metastases. J Clin Oncol 2000;18:3925-35.
13. James JJ, Evans AJ, Pinder SE, Gutteridge E, Cheung KL, Chan S, et al. Bone metastases from breast carcinoma: Histopathological radiological correlations and prognostic features. Br J Cancer 2003;89:660-5.
14. Purushotham A, Shamil E, Cariati M, Agbaje O, Muhidin A, Gillett C, et al. Age at diagnosis and distant metastasis in breast cancera surprising inverse relationship. Eur J Cancer 2014;50:1697-705.
15. Xiao W, Zheng S, Yang A, Zhang X, Zou Y, Tang H, et al. Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: A population-based study. Cancer Manag Res 2018;10:5329-38.
16. Diessner J, Wischnewsky M, Stüber T, Stein R, Krockenberger M, Häusler S, et al. Evaluation of clinical parameters influencing the development of bone metastasis in breast cancer. BMC Cancer 2016;16:307.
17. Irawan C, Hukom R, Prayogo N. Factors associated with bone metastasis in breast cancer: A preliminary study in an Indonesian population. Acta Med Indones2008;40:178-80.
18. Coleman RE, Rubens RD. The clinical course of bone metastases from breast cancer. Br J Cancer 1987;55:61-6.
19. Huszno J, Nowara E. Risk factors for disease progression in HER2-positive breast cancer patients based on the location of metastases. PrzMenopauzalny2015;14:173-7.
20. Yazdani A, Dorri S, Atashi A, Shirafkan H, Zabolinezhad H. Bone metastasis prognostic factors in breast cancer. Breast Cancer (Auckl) 2019;13:1178223419830978.


Dr. Purnima Thakur	Dr. Vishal Verma	Dr. Ekta Dogra	Dr. Ankur Gupta	Dr. Manish Gupta	Dr. Vikas Fotedar

How to Cite this article: Thakur P, Verma V, Dogra E, Gupta A, Gupta M, Fotedar V. Identification of Breast Cancer Patients at Risk for Bone Metastasis – A Case–Control Study. Journal of Bone and Soft Tissue Tumors May-August 2019;5(2): 15-19.

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Quality of Life and Functional Outcome of Patients Treated with Revision Limb Salvage Surgery and Amputation: A Cross-Sectional Study

May 10, 2019/in Vol 5 | Issue 2 | May-Aug 2019 /by jbstadmin

Author M S Satish[1], Srinivasan Vijay[1], Anand Raja[2], Surendran Veeraiah[3]
[1]Department of Physiotherapist, Cancer Institute (WIA), Chennai, Tamil Nadu, India,
[2]Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India,
[3]Department of Psycho-Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.

Address of Correspondence
Dr. M S Satish,
Department of Physiotherapist, Cancer Institute(WIA), Adyar, Chennai, Tamil Nadu, India.
E-mail: ms.satish@cancerinstitutewia.org

Abstract
Context: Despite the advances in surgical treatments and chemotherapy, obtaining an optimal outcome in the treatment of musculoskeletal tumors or sarcomas is still quite challenging. This can be managed by improving various factors such as survival and recurrence rate, longevity of the prosthesis, functional outcome, and quality of life (QOL) of patients. However, not much attention has been given to this issue in India.
Aims: The aim of the study was to examine the QOL and functional outcome of musculoskeletal cancer patients who were treated with revision limb salvage surgery (LSS) and those who underwent above-knee (AK) amputation followed by rehabilitation with Akprosthesis.
Settings and Design: A cross-sectional study was carried out between May 2015 and April 2016 at Physiotherapy Out patient Department of Cancer Institute, Chennai.
Materials and Methods: Thirty-two patients aged between 15and 60 years, treated with revision LSS (n=15) and those rehabilitated with prosthesis after AK amputation (n=17)were assessed for QOL and functional outcome. Cancer Institute QOL questionnaire was used to assess QOL and Musculoskeletal Tumor Society score was used to find the functional outcome of these patients.
Statistical analysis: Descriptive statistics, student’s t-test, and Chi-square test were used to analyze the data using SPSS version 13.
Results: The revision LSS patients were found to have a better functional outcome as well as QOL than the amputees. Yet another aspect of QOL, namely, fear of recurrence was much lesser among AK amputees than revision LSS patients.
Conclusions: The findings of this study imply that revision LSS has higher advantages in terms of functional outcome and QOL of patients compared to amputation, though patients treated with revision LSS were found to have increased fear of recurrence and pain than the amputees.
Keywords: Revision limb salvage surgery, quality of life, functional outcome, amputation, musculoskeletal tumor.

References
1. Chauhan A, Joshi GR, Chopra BK, Ganguly M, Reddy GR. Limb salvage surgery in bone tumors: A retrospective study of 50 cases in a single center. Indian J Surg Oncol 2013;4:248-54.
2. Allison DC, Carney SC, Ahlmann ER, Hendifar A, Chawla S, Fedenko A, et al. A meta-analysis of osteosarcoma outcomes in the modern medical era. Sarcoma 2012;2012:704872.
3. Reddy KI, Wafa H, Gaston CL, Grimer RJ, Abudu AT, Jeys LM, et al. Does amputation offer any survival benefit over limb salvage in osteosarcoma patients with poor chemonecrosis and close margins? Bone Joint J 2015;97-B:115-20.
4. Yoshida Y, Osaka S, Kojima T, Taniguchi M, Osaka E, Tokuhashi Y, et al. Revision of tumor prosthesis of the knee joint. Eur J Orthop Surg Traumatol2012;22:387-94.
5. Davidson JH, Jones LE, Cornet J, Cittarelli T. Management of the multiple limb amputee. DisabilRehabil2002;24:688-99.
6. Zidarov D, Swaine B, Gauthier-Gagnon C. Quality of life of persons with lower-limb amputation during rehabilitation and at 3-month follow-up. Arch Phys Med Rehabil2009;90:634-45.
7. Robert RS, Ottaviani G, Huh WW, Palla S, Jaffe N. Psychosocial and functional outcomes in long-term survivors of osteosarcoma: A comparison of limb-salvage surgery and amputation. Pediatr Blood Cancer 2010;54:990-9.
8. Aksnes LH, Bauer HC, Jebsen NL, Follerås G, Allert C, Haugen GS, et al. Limb-sparing surgery preserves more function than amputation: A Scandinavian sarcoma group study of 118 patients. J Bone Joint Surg Br 2008;90:786-94.
9. Zahlten-Hinguranage A, Bernd L, Ewerbeck V, Sabo D. Equal quality of life after limb-sparing or ablative surgery for lower extremity sarcomas. Br J Cancer 2004;91:1012-4.
10. Weddington WW Jr.,Segraves KB, Simon MA. Psychological outcome of extremity sarcoma survivors undergoing amputation or limb salvage. J Clin Oncol 1985;3:1393-9.
11. Meyers PA, Gorlick R. Osteosarcoma. Pediatr Clin North Am 1997;44:973-89.
12. Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin OrthopRelat Res 1993;286:241-6.
13. Vidhubala E, Kannan RR, Mani SC, Karthikesh K, Muthuvel R, Surendran V, et al. Validation of quality of life questionnaire for patients with cancer Indian scenario. Indian J Cancer 2005;42:138-44.
14. Eiser C, Darlington AS, Stride CB, Grimer R. Quality of life implications as a consequence of surgery: Limb salvage, primary and secondary amputation. Sarcoma 2001;5:189-95.
15. Ruggieri P, Mavrogenis AF, Mercuri M. Quality of life following limb-salvage surgery for bone sarcomas. Expert Rev Pharmacoecon Outcomes Res 2011;11:59-73.
16. Mason GE, Aung L, Gall S, Meyers PA, Butler R, Krüg S, et al. Quality of life following amputation or limb preservation in patients with lower extremity bone sarcoma. Front Oncol 2013;3:210.
17. Hopyan S, Tan JW, Graham HK, Torode IP. Function and upright time following limb salvage, amputation, and rotationplasty for pediatric sarcoma of bone. J PediatrOrthop2006;26:405-8.
18. Davis AM, Devlin M, Griffin AM, Wunder JS, Bell RS. Functional outcome in amputation versus limb sparing of patients with lower extremity sarcoma: A matched case-control study. Arch Phys Med Rehabil1999;80:615-8.
19. Malek F, Somerson JS, Mitchel S, Williams RP. Does limb-salvage surgery offer patients better quality of life and functional capacity than amputation? Clin OrthopRelat Res 2012;470:2000-6.
20. Renard AJ, Veth RP, Schreuder HW, van Loon CJ, Koops HS, van Horn JR, et al. Function and complications after ablative and limb-salvage therapy in lower extremity sarcoma of bone. J Surg Oncol 2000;73:198-205.
21. Ginsberg JP, Rai SN, Carlson CA, Meadows AT, Hinds PS, Spearing EM, et al. A comparative analysis of functional outcomes in adolescents and young adults with lower-extremity bone sarcoma. Pediatr Blood Cancer 2007;49:964-9.
22. Bekkering WP, Vliet Vlieland TP, Koopman HM, Schaap GR, Bart Schreuder HW, Beishuizen A, et al. Functional ability and physical activity in children and young adults after limb-salvage or ablative surgery for lower extremity bone tumors. J Surg Oncol 2011;103:276-82.
23. Rougraff BT, Simon MA, Kneisl JS, Greenberg DB, Mankin HJ. Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. A long-term oncological, functional, and quality-of-life study. J Bone Joint Surg Am 1994;76:649-56.


Dr. M S Satish	Dr. Srinivasan Vijay	Dr. Anand Raja	Dr. Surendran Veeraiah

How to Cite this article: Satish M S, Vijay S, Raja A, Surendran V. Quality of Life and Functional Outcome of Patients Treated with Revision Limb Salvage Surgery and Amputation: A Cross-Sectional Study. Journal of Bone and Soft Tissue Tumors May-August 2019;5(2): 11-14.

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Identification of Breast Cancer Patients at Risk for Bone Metastasis – A Case–Control Study

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Quality of Life and Functional Outcome of Patients Treated with Revision Limb Salvage Surgery and Amputation: A Cross-Sectional Study

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Identification of Breast Cancer Patients at Risk for Bone Metastasis – A Case–Control Study

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Quality of Life and Functional Outcome of Patients Treated with Revision Limb Salvage Surgery and Amputation: A Cross-Sectional Study

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