Skip to main content

Brian Eugene Brigman

Professor of Orthopaedic Surgery
Orthopaedic Surgery
Box 3312 Med Ctr, Durham, NC
1578 White Zone DS, Durham, NC

Selected Publications


Safety and efficacy of pembrolizumab, radiation therapy, and surgery versus radiation therapy and surgery for stage III soft tissue sarcoma of the extremity (SU2C-SARC032): an open-label, randomised clinical trial.

Journal Article Lancet · November 23, 2024 BACKGROUND: Approximately half of patients with localised, high-risk soft tissue sarcoma of the extremity develop metastases. We aimed to assess whether the addition of pembrolizumab to preoperative radiotherapy and surgery would improve disease-free survi ... Full text Link to item Cite

Case of a CIC::DUX4 fusion gene in a vascular neoplasm extends the spectrum of CIC-rearranged sarcomas.

Journal Article J Cutan Pathol · November 2024 CIC-rearranged sarcomas comprise a group of exceptionally aggressive round-cell sarcomas. These tumors most commonly demonstrate CIC::DUX4 fusion and show similar histopathology to Ewing sarcomas, though lesions mimicking vascular neoplasms have recently b ... Full text Link to item Cite

Cell-cycle phase progression analysis identifies three unique phenotypes in soft tissue sarcoma.

Journal Article BMC Cancer · October 17, 2024 PURPOSE: Loddo et al. (Br J Cancer 100:959-70, 2009) established the prognostic significance of cell cycle markers and "Cell-Cycle Phenotypes" in breast carcinoma. This study aims to 1) identify prognostic cell-cycle markers in sarcoma, and 2) assess the p ... Full text Link to item Cite

Locking plate augmentation of polymethylmethacrylate-filled distal femoral defects: A biomechanical study.

Journal Article J Orthop Res · September 1, 2024 Benign, locally aggressive tumors of the distal femur are typically treated with intralesional curettage and polymethylmethacrylate (PMMA) cementation. However, it is not known whether plate fixation should be added to biomechanically augment these PMMA-fi ... Full text Link to item Cite

Exploring versatile applications of a vacuum-assisted bone harvester in orthopedic surgery.

Journal Article BMC Musculoskelet Disord · August 31, 2024 BACKGROUND: Orthopedic procedures often require removing bone or pathological tissue, with traditional methods involving instruments like curettes and rongeurs. However, these methods can be time-consuming and lead to increased blood loss. To mitigate thes ... Full text Link to item Cite

ATRX and Its Prognostic Significance in Soft Tissue Sarcoma.

Journal Article Sarcoma · 2024 PURPOSE: Recently, the association between ATRX and a more aggressive sarcoma phenotype has been shown. We performed a retrospective study of sarcomas from an individual institution to evaluate ATRX as a prognosticator in soft tissue sarcoma. Experimental ... Full text Link to item Cite

Tripod Fixation of Periacetabular Metastatic Lesions Using the IlluminOss Device.

Journal Article JBJS Essent Surg Tech · 2024 BACKGROUND: Percutaneous tripod fixation of periacetabular lesions is performed at our institution for patients with metastatic bone disease and a need for quick return to systemic therapy. We have begun to use the IlluminOss Photodynamic Bone Stabilizatio ... Full text Link to item Cite

Regional anesthesia is associated with improved metastasis free survival after surgical resection of bone sarcomas.

Journal Article J Orthop Res · December 2023 There is increasing evidence that perioperative factors, including type of anesthesia, may be an important consideration regarding oncological disease progression. Previous studies have suggested that regional anesthesia can improve oncological outcomes by ... Full text Link to item Cite

Giant cell tumor of bone in the pediatric population: a retrospective study highlighting cases of metaphyseal only location and increased local recurrence rates in skeletally immature patients.

Journal Article Skeletal Radiol · December 2023 OBJECTIVE: To describe the presentation of giant cell tumors (GCT) of the bone in the pediatric population to (1) improve the differential diagnosis of pediatric bone tumors and (2) identify the origin of GCT. Understanding the origin of bone tumors assist ... Full text Link to item Cite

Tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma.

Journal Article BMC Cancer · June 23, 2023 BACKGROUND: Cartilaginous neoplasms can be challenging to grade; there is a need to create an evidence-based rubric for grading. The goal of this study was to identify histopathologic features of chondrosarcoma that were associated with 5-year survival and ... Full text Link to item Cite

Outcomes following Free Fibula Physeal Transfer for Pediatric Proximal Humerus Reconstruction: An International Multi-Institutional Study.

Journal Article Plast Reconstr Surg · April 1, 2023 BACKGROUND: Vascularized fibula epiphyseal flap was first described in 1998 for proximal humeral reconstruction in children/infants. The authors aim to review their international, multi-institutional, long-term outcomes. METHODS: An international, multi-in ... Full text Link to item Cite

Juxtametallic Bipolar Bone Radiofrequency Ablation: Thermal Monitoring in an Ex-Vivo Model with Specimen MRI and Histopathologic Correlation.

Journal Article J Vasc Interv Radiol · December 2022 PURPOSE: To measure the ablation zone temperature and nontarget tissue temperature during radiofrequency (RF) ablation in bone containing metal instrumentation versus no metal instrumentation (control group). MATERIALS AND METHODS: Ex vivo experiments were ... Full text Link to item Cite

Antibiotic Prophylaxis for Megaprosthetic Reconstructions: Drug and Dosing May Matter More than Duration.

Journal Article Antimicrob Agents Chemother · October 18, 2022 In orthopedic oncology, the implant of a megaprosthetic device is standard of care after large-scale tumor resection involving segmental removal of bone. Infection remains the leading cause of implant failure, often resulting in major morbidity. Perioperat ... Full text Link to item Cite

Intraoperative angiography imaging correlates with wound complications following soft tissue sarcoma resection.

Journal Article J Orthop Res · October 2022 For soft tissue sarcoma patients receiving preoperative radiation therapy, wound complications are common and potentially devastating. The purpose of this study was to assess the feasibility of intraoperative indocyanine green fluorescent angiography (ICGA ... Full text Link to item Cite

Investigating readmission rates for patients undergoing oncologic resection and endoprosthetic reconstruction for primary sarcomas and tumors involving bone.

Journal Article J Surg Oncol · August 2022 BACKGROUND: Little is known about the drivers of readmission in patients undergoing Orthopaedic oncologic resection. The goal of this study was to identify factors independently associated with 90-day readmission for patients undergoing oncologic resection ... Full text Link to item Cite

Identifying Modifiable and Non-modifiable Risk Factors of Readmission and Short-Term Mortality in Chondrosarcoma: A National Cancer Database Study.

Journal Article Ann Surg Oncol · February 2022 BACKGROUND: Limited data are available to inform the risk of readmission and short-term mortality in musculoskeletal oncology. The goal of this study was to identify factors independently associated with 30-day readmission and 90-day mortality following su ... Full text Link to item Cite

Why Do Patients Undergoing Extremity Prosthetic Reconstruction for Metastatic Disease Get Readmitted?

Journal Article The Journal of arthroplasty · February 2022 BackgroundOrthopedic oncology patients are particularly susceptible to increased readmission rates and poor surgical outcomes, yet little is known about readmission rates. The goal of this study is to identify factors independently associated with ... Full text Cite

Extent of tumor fibrosis/hyalinization and infarction following neoadjuvant radiation therapy is associated with improved survival in patients with soft-tissue sarcoma.

Journal Article Cancer Med · January 2022 INTRODUCTION: Current standard of care for most intermediate and high-grade soft-tissue sarcomas (STS) includes limb-preserving surgical resection with either neoadjuvant radiation therapy (NRT) or adjuvant radiation therapy. To date, there have been a few ... Full text Link to item Cite

Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study.

Journal Article Br J Anaesth · December 2021 BACKGROUND: Cognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients. METHODS: We enrolled 140 English-speaking patients ≥60 yr old scheduled fo ... Full text Open Access Link to item Cite

Identifying Modifiable and Non-modifiable Risk Factors of Readmission and Short-Term Mortality in Osteosarcoma: A National Cancer Database Study.

Journal Article Ann Surg Oncol · November 2021 BACKGROUND: There are limited data to inform risk of readmission and short-term mortality in musculoskeletal oncology. The goal of this study was to identify factors independently associated with 30-day readmission and 90-day mortality following surgical r ... Full text Link to item Cite

Reverse total shoulder arthroplasty for oncologic reconstruction of the proximal humerus: a systematic review.

Journal Article J Shoulder Elbow Surg · November 2021 BACKGROUND: In recent years, there has been growing interest in the use of reverse total shoulder arthroplasty (rTSA) for reconstruction of the proximal humerus after oncologic resection. However, the indications and outcomes of oncologic rTSA remain uncle ... Full text Link to item Cite

Prophylactic Antibiotic Regimens In Tumor Surgery (PARITY): a multi-center randomized controlled study comparing alternative antibiotic regimens in patients undergoing tumor resections with endoprosthetic replacements-a statistical analysis plan.

Journal Article Trials · March 22, 2021 BACKGROUND: Limb salvage with endoprosthetic reconstruction is the current standard practice for the surgical management of lower extremity bone tumors in skeletally mature patients and typically includes tumor resection followed by the functional limb rec ... Full text Link to item Cite

Humeral Shaft Fracture With Placement of an Intramedullary Nail Through an Unrecognized Sarcoma.

Journal Article J Am Acad Orthop Surg Glob Res Rev · February 19, 2021 CASE: A 72-year-old man underwent intramedullary nailing of a humeral diaphysis fracture with passage through an unrecognized pathologic fracture. Four months later, a biopsy of a soft-tissue mass in the arm revealed pleomorphic undifferentiated sarcoma. O ... Full text Link to item Cite

Immunomodulatory lipid mediator profiling of cerebrospinal fluid following surgery in older adults.

Journal Article Sci Rep · February 4, 2021 Arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) derived lipids play key roles in initiating and resolving inflammation. Neuro-inflammation is thought to play a causal role in perioperative neurocognitive disorders, yet th ... Full text Open Access Link to item Cite

Cerebrospinal Fluid Proteome Changes in Older Non-Cardiac Surgical Patients with Postoperative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2021 BACKGROUND: Postoperative cognitive dysfunction (POCD), a syndrome of cognitive deficits occurring 1-12 months after surgery primarily in older patients, is associated with poor postoperative outcomes. POCD is hypothesized to result from neuroinflammation; ... Full text Open Access Link to item Cite

The Utility of Chest Imaging for Surveillance of Atypical Lipomatous Tumors.

Journal Article Sarcoma · 2021 BACKGROUND: Unlike other soft tissue sarcomas, atypical lipomatous tumors (ALTs) are thought to have a low propensity for metastasis. Despite this, a standard of care for pulmonary metastasis (PM) surveillance has not been established. This study aimed to ... Full text Link to item Cite

The Role of Electronic Learning in Orthopaedic Graduate Medical Training: A Consensus From Leaders in Orthopaedic Training Programs

Journal Article Journal of the American Academy of Orthopaedic Surgeons · December 24, 2020 The US orthopaedic graduate medical education system is based on long established methods in education, but academic leaders at orthopaedic institutions now have the ability to use electronic learning innovations. Hospital for Special Surgery gathe ... Full text Cite

Limb salvage versus amputation in patients with osteosarcoma of the extremities: an update in the modern era using the National Cancer Database.

Journal Article BMC Cancer · October 14, 2020 BACKGROUND: Historically, amputation was the primary surgical treatment for osteosarcoma of the extremities; however, with advancements in surgical techniques and chemotherapies limb salvage has replaced amputation as the dominant treatment paradigm. This ... Full text Link to item Cite

Defining a textbook surgical outcome for patients undergoing surgical resection of intermediate and high-grade soft tissue sarcomas of the extremities.

Journal Article J Surg Oncol · October 2020 BACKGROUND: Quality measures for the surgical management soft tissue sarcoma of the extremity are limited. The purpose of this study was to define a textbook surgical outcome (TO) for soft tissue sarcoma of the extremities (STS-E) and to examine its associ ... Full text Link to item Cite

Does facility volume influence survival in patients with primary malignant bone tumors of the vertebral column? A comparative cohort study.

Journal Article Spine J · July 2020 BACKGROUND CONTEXT: Facility volume has been correlated with survival in many cancers. This relationship has not been established in primary malignant bone tumors of the vertebral column (BTVC). PURPOSE: To investigate whether facility patient volume is as ... Full text Open Access Link to item Cite

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.

Journal Article J Neurol · July 2020 OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort st ... Full text Link to item Cite

Preclinical Testing of a Novel Niclosamide Stearate Prodrug Therapeutic (NSPT) Shows Efficacy Against Osteosarcoma.

Journal Article Mol Cancer Ther · July 2020 Therapeutic advances for osteosarcoma have stagnated over the past several decades, leading to an unmet clinical need for patients. The purpose of this study was to develop a novel therapy for osteosarcoma by reformulating and validating niclosamide, an es ... Full text Open Access Link to item Cite

The Role of Radiotherapy for Chordoma Patients Managed With Surgery: Analysis of the National Cancer Database.

Journal Article Spine (Phila Pa 1976) · June 15, 2020 STUDY DESIGN: Retrospective review. OBJECTIVE: To determine if adjuvant radiation therapy (RT) improves overall survival (OS) following surgical resection of chordomas. SUMMARY OF BACKGROUND DATA: The role of RT for the treatment of chordomas remains incom ... Full text Link to item Cite

The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ... Full text Open Access Link to item Cite

Epidemiologic and survival trends in adult primary bone tumors of the spine.

Journal Article Spine J · December 2019 BACKGROUND CONTEXT: Malignant primary spinal tumors are rare making it difficult to perform large studies comparing epidemiologic, survival, and treatment trends. We investigated the largest registry of primary bone tumors, the National Cancer Database (NC ... Full text Open Access Link to item Cite

Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study.

Journal Article Anesth Analg · November 2019 Animal models suggest postoperative cognitive dysfunction may be caused by brain monocyte influx. To study this in humans, we developed a flow cytometry panel to profile cerebrospinal fluid (CSF) samples collected before and after major noncardiac surgery ... Full text Open Access Link to item Cite

Soft Tissue Sarcoma of the Extremities: What Is the Value of Treating at High-volume Centers?

Journal Article Clin Orthop Relat Res · April 2019 BACKGROUND: For many cancer types, survival is improved when patients receive management at treatment centers that encounter high numbers of patients annually. This correlation may be more important with less common malignancies such as sarcoma. Existing e ... Full text Link to item Cite

Microsurgery in musculoskeletal oncology.

Journal Article Eur J Orthop Surg Traumatol · February 2019 Sarcomas are rare mesenchymal bone and soft tissue tumors of the musculoskeletal system. In the past, the primary treatment modality was amputation of the involved limb and the 5-year survival was very low for high-grade tumors. During the last three decad ... Full text Link to item Cite

Revisiting the Role of Radiation Therapy in Chondrosarcoma: A National Cancer Database Study.

Journal Article Sarcoma · 2019 BACKGROUND: Although chondrosarcomas (CS) are mostly considered radioresistant, advancements in radiotherapy have brought attention to its use in these patients. Using the largest registry of primary bone tumors, the National Cancer Database (NCDB), we sou ... Full text Link to item Cite

New Techniques for Diagnosis and Treatment of Musculoskeletal Tumors: Methods of Intraoperative Margin Detection

Conference Techniques in Orthopaedics · September 1, 2018 Although frozen section analysis remains the standard for intraoperative margin detection for some cancers, there are critical limitations with using this method in the treatment of musculoskeletal tumors. Extensive work has been done to develop more accur ... Full text Cite

Wound Surface Area as a Risk Factor for Flap Complications among Patients with Open Fractures.

Journal Article Plast Reconstr Surg · July 2018 BACKGROUND: Soft-tissue complications often dictate the success of limb salvage and the overall outcome of open fractures. Based on prior work at the R Adams Cowley Shock Trauma Center, the authors hypothesize that wounds larger than 200 cm are associated ... Full text Link to item Cite

The Role of Reconstructive Surgery After Skeletal and Soft Tissue Sarcoma Resection.

Journal Article Ann Plast Surg · June 2018 BACKGROUND: Skeletal and soft tissue reconstruction after sarcoma resection remains challenging. The use of advanced reconstructive techniques has been shown to improve function and increase rates of limb salvage. This study aims to analyze the utilization ... Full text Link to item Cite

Race is an independent predictor of survival in patients with soft tissue sarcoma of the extremities.

Journal Article BMC Cancer · April 27, 2018 BACKGROUND: In the United States, race and socioeconomic status are well known predictors of adverse outcomes in several different cancers. Existing evidence suggests that race and socioeconomic status may impact survival in soft tissue sarcoma (STS). We i ... Full text Link to item Cite

Influence of Trainee Experience on Choice of Orthopaedic Subspecialty Fellowship.

Journal Article J Am Acad Orthop Surg · February 1, 2018 INTRODUCTION: Most orthopaedic surgery residents elect to pursue additional subspecialty training; however, factors influencing the choice of subspecialty and the ways that these factors change during training are not well understood. The aim of this inves ... Full text Link to item Cite

The Value of MRI in Distinguishing Subtypes of Lipomatous Extremity Tumors Needs Reassessment in the Era of MDM2 and CDK4 Testing.

Journal Article Sarcoma · 2018 INTRODUCTION: Extremity lipomas and well-differentiated liposarcomas (WDLs) are difficult to distinguish on MR imaging. We sought to evaluate the accuracy of MRI interpretation using MDM2 amplification, via fluorescence in-situ hybridization (FISH), as the ... Full text Link to item Cite

Beyond Mirels: Factors Influencing Surgical Outcome of Metastasis to the Extremities in the Modern Era.

Journal Article J Surg Orthop Adv · 2018 Mirels scoring system for determining prophylactic stabilization need of skeletal metastases includes a limited number of variables and does not differentiate between procedure types. This study sought to identify additional variables associated with surgi ... Link to item Cite

Factors Influencing Orthopedic Surgery Residents' Choice of Subspecialty Fellowship.

Journal Article Orthopedics · September 1, 2017 In the setting of increasing student debt, a rapidly changing health care system, and growing transparency in the age of outcome reporting, residents have many factors to consider when determining which fellowship to pursue. An institutional review board-a ... Full text Link to item Cite

Tumors of the Epiphyses.

Journal Article JBJS Rev · May 2017 Full text Link to item Cite

Vascularized Fibula-Based Physis Transfer: A Follow-Up Study of Longitudinal Bone Growth and Complications.

Journal Article Plast Reconstr Surg Glob Open · May 2017 BACKGROUND: The vascularized free fibula epiphyseal transfer provides an option for the preservation of limb lengthening after resection of the proximal humerus in pediatric sarcoma patients. The purpose of this study was to provide a long-term follow-up o ... Full text Open Access Link to item Cite

The stability of the hip after the use of a proximal femoral endoprosthesis for oncological indications: analysis of variables relating to the patient and the surgical technique.

Journal Article Bone Joint J · April 2017 AIMS: Instability of the hip is the most common mode of failure after reconstruction with a proximal femoral arthroplasty (PFA) using an endoprosthesis after excision of a tumour. Small studies report improved stability with capsular repair of the hip and ... Full text Link to item Cite

NCCN Guidelines Insights: Bone Cancer, Version 2.2017.

Journal Article J Natl Compr Canc Netw · February 2017 The NCCN Guidelines for Bone Cancer provide interdisciplinary recommendations for treating chordoma, chondrosarcoma, giant cell tumor of bone, Ewing sarcoma, and osteosarcoma. These NCCN Guidelines Insights summarize the NCCN Bone Cancer Panel's guideline ... Full text Link to item Cite

Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults.

Journal Article Front Syst Neurosci · 2017 Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, incr ... Full text Open Access Link to item Cite

An NLRP3 Mutation Causes Arthropathy and Osteoporosis in Humanized Mice.

Journal Article Cell Rep · December 13, 2016 The NLRP3 inflammasome plays a critical role in host defense by facilitating caspase I activation and maturation of IL-1β and IL-18, whereas dysregulation of inflammasome activity results in autoinflammatory disease. Factors regulating human NLRP3 activity ... Full text Link to item Cite

A Novel Imaging System Distinguishes Neoplastic from Normal Tissue During Resection of Soft Tissue Sarcomas and Mast Cell Tumors in Dogs.

Journal Article Vet Surg · August 2016 OBJECTIVE: To assess the ability of a novel imaging system designed for intraoperative detection of residual cancer in tumor beds to distinguish neoplastic from normal tissue in dogs undergoing resection of soft tissue sarcoma (STS) and mast cell tumor (MC ... Full text Link to item Cite

Synovial Chondromatosis.

Journal Article JBJS Rev · May 10, 2016 Synovial chondromatosis is a rare, benign condition of unknown etiology in which the synovium undergoes metaplasia leading to cartilaginous nodules that ultimately break free, mineralize, and even ossify. The most commonly involved joint is the knee. Patie ... Full text Link to item Cite

Angiomatoid fibrous histiocytoma: novel MR imaging findings.

Journal Article Skeletal Radiol · May 2016 OBJECTIVE: To describe novel MR imaging features, and clinical characteristics of soft tissue angiomatoid fibrous histiocytoma (AFH) at presentation, local recurrence, and metastases. MATERIALS AND METHODS: We described the MRI findings of six cases of his ... Full text Link to item Cite

Myogenic transcription factors regulate pro-metastatic miR-182.

Journal Article Oncogene · April 7, 2016 Approximately 30% of patients with soft-tissue sarcoma die from pulmonary metastases. The mechanisms that drive sarcoma metastasis are not well understood. Recently, we identified miR-182 as a driver of sarcoma metastasis in a primary mouse model of soft-t ... Full text Link to item Cite

A mouse-human phase 1 co-clinical trial of a protease-activated fluorescent probe for imaging cancer.

Journal Article Sci Transl Med · January 6, 2016 Local recurrence is a common cause of treatment failure for patients with solid tumors. Intraoperative detection of microscopic residual cancer in the tumor bed could be used to decrease the risk of a positive surgical margin, reduce rates of reexcision, a ... Full text Link to item Cite

Successful Translation of Fluorescence Navigation During Oncologic Surgery: A Consensus Report.

Journal Article J Nucl Med · January 2016 Navigation with fluorescence guidance has emerged in the last decade as a promising strategy to improve the efficacy of oncologic surgery. To achieve routine clinical use, the onus is on the surgical community to objectively assess the value of this techni ... Full text Link to item Cite

Innovations in Intraoperative Tumor Visualization.

Journal Article Orthop Clin North Am · January 2016 In the surgical management of solid tumors, adequacy of tumor resection has implications for local recurrence and survival. The standard method of intraoperative identification of tumor margin is frozen section pathologic analysis, which is time-consuming ... Full text Link to item Cite

A Fluorescence-Guided Laser Ablation System for Removal of Residual Cancer in a Mouse Model of Soft Tissue Sarcoma.

Journal Article Theranostics · 2016 The treatment of soft tissue sarcoma (STS) generally involves tumor excision with a wide margin. Although advances in fluorescence imaging make real-time detection of cancer possible, removal is limited by the precision of the human eye and hand. Here, we ... Full text Open Access Link to item Cite

The use of radiation therapy in localized high-grade soft tissue sarcoma and potential impact on survival.

Journal Article Ann Surg Oncol · September 2015 BACKGROUND: It is a consensus that radiation therapy (RT) should be applied for all large, deep, high-grade soft tissue sarcomas (STS). Therefore, we investigated the National Cancer Database (NCDB) to study how these guidelines are being followed, to dete ... Full text Link to item Cite

Comparison of Acute Histologic and Biomechanical Effects of Radiofrequency Ablation and Cryoablation on Periarticular Structures in a Swine Model.

Journal Article J Vasc Interv Radiol · August 2015 PURPOSE: To compare the acute effects of radiofrequency (RF) ablation and cryoablation on the structural integrity of nontarget periarticular tissues that may be placed at risk during percutaneous bone ablation. MATERIALS AND METHODS: RF ablation and cryoa ... Full text Link to item Cite

The Use of Radiation Therapy in Well-Differentiated Soft Tissue Sarcoma of the Extremities: An NCDB Review.

Journal Article Sarcoma · 2015 Objective. This study investigated patterns of utilization of radiation therapy (RT) and correlated this with overall survival by assessing patients with well-differentiated soft tissue sarcoma of the extremity (STS-E) in the National Cancer Database (NCDB ... Full text Link to item Cite

Extranodal Castleman disease of the extremities: a case report and review of the literature.

Journal Article Skeletal Radiol · November 2014 Castleman disease is a rare lymphoproliferative disorder of unknown etiology that most commonly presents as a mediastinal nodal mass or, in the extranodal form of the disease, a mass located in the mediastinum or retroperitoneum. It is exceptionally uncomm ... Full text Link to item Cite

The phosphaturic mesenchymal tumor: why is definitive diagnosis and curative surgery often delayed?

Journal Article Clin Orthop Relat Res · November 2013 BACKGROUND: Tumor-induced osteomalacia is a paraneoplastic syndrome resulting in renal phosphate wasting and decreased bone mineralization. Phosphaturic mesenchymal tumors represent a rare etiology of tumor-induced osteomalacia. Nonspecific symptoms of fat ... Full text Link to item Cite

Vascularized fibula-based physis transfer for pediatric proximal humerus reconstruction.

Journal Article Plast Reconstr Surg · August 2013 UNLABELLED: Free vascularized fibular transfer has become a standard procedure in upper extremity reconstruction after resection of osteogenic tumors. The authors present two rare pediatric cases of high-grade osteosarcoma resection of the proximal humerus ... Full text Link to item Cite

Pancarpal synovial and tenosynovial chondromatosis in a 65-year-old man: a highly unusual presentation of a common condition.

Journal Article Am J Orthop (Belle Mead NJ) · August 2013 Synovial chondromatosis is a rare, benign, metaplastic condition in which synovial tissue becomes hyperplastic, and foci of cartilaginous metaplasia develop in the synovial membranes of joints, bursae, or tendon sheaths. Involvement is most commonly monoar ... Link to item Cite

Practical radiation oncology for extremity sarcomas.

Journal Article Surg Oncol Clin N Am · July 2013 Soft tissue sarcomas are rare cancers. They should be managed by a multidisciplinary team with experience caring for these diverse malignancies. Local control is frequently achieved with a combination of radiation therapy and surgery. This article reviews ... Full text Link to item Cite

Bone cancer.

Journal Article J Natl Compr Canc Netw · June 1, 2013 Primary bone cancers are extremely rare neoplasms, accounting for fewer than 0.2% of all cancers. The evaluation and treatment of patients with bone cancers requires a multidisciplinary team of physicians, including musculoskeletal, medical, and radiation ... Full text Link to item Cite

Imaging primary mouse sarcomas after radiation therapy using cathepsin-activatable fluorescent imaging agents.

Journal Article Int J Radiat Oncol Biol Phys · May 1, 2013 PURPOSE: Cathepsin-activated fluorescent probes can detect tumors in mice and in canine patients. We previously showed that these probes can detect microscopic residual sarcoma in the tumor bed of mice during gross total resection. Many patients with soft ... Full text Link to item Cite

A novel imaging system permits real-time in vivo tumor bed assessment after resection of naturally occurring sarcomas in dogs.

Journal Article Clin Orthop Relat Res · March 2013 BACKGROUND: Treatment of soft tissue sarcoma (STS) includes complete tumor excision. However, in some patients, residual sarcoma cells remain in the tumor bed. We previously described a novel hand-held imaging device prototype that uses molecular imaging t ... Full text Link to item Cite

Oncogene-dependent control of miRNA biogenesis and metastatic progression in a model of undifferentiated pleomorphic sarcoma.

Journal Article J Pathol · January 2013 Undifferentiated pleomorphic sarcoma (UPS) is one of the most common soft tissue malignancies. Patients with large, high-grade sarcomas often develop fatal lung metastases. Understanding the mechanisms underlying sarcoma metastasis is needed to improve tre ... Full text Link to item Cite

The vascularized fibular graft in the pediatric upper extremity: a durable, biological solution to large oncologic defects.

Journal Article Sarcoma · 2013 Skeletal reconstruction after large tumor resection is challenging. The free vascularized fibular graft (FVFG) offers the potential for rapid autograft incorporation as well as growing physeal transfer in pediatric patients. We retrospectively reviewed ele ... Full text Open Access Link to item Cite

Intraoperative detection and removal of microscopic residual sarcoma using wide-field imaging.

Journal Article Cancer · November 1, 2012 BACKGROUND: The goal of limb-sparing surgery for a soft tissue sarcoma of the extremity is to remove all malignant cells while preserving limb function. After initial surgery, microscopic residual disease in the tumor bed will cause a local recurrence in a ... Full text Link to item Cite

Surgical treatment and prognosis in patients with high-grade soft tissue malignant fibrous histiocytoma of the extremities.

Journal Article Arch Orthop Trauma Surg · July 2012 BACKGROUND: Malignant fibrous histiocytoma (MFH) of soft tissue is one of the most common sarcoma in adulthood. However, only a few series have separately studied the clinical behavior and prognosis of this malignancy. METHODS: We retrospectively reviewed ... Full text Link to item Cite

Leiomyosarcoma of the somatic soft tissues.

Journal Article J Surg Orthop Adv · 2012 Leiomyosarcomas of the somatic soft tissues are tumors of smooth muscle origin that occur in the extremities. These lesions are commonly high-grade tumors that carry a poor prognosis. Recommended treatment often includes wide excision and chemotherapy or r ... Full text Link to item Cite

[Femur reconstruction using combined autologous fibula transfer and humeral allograft].

Journal Article Chirurg · December 2011 Wide resection far into the femoral metaphysis may be required to treat malignant bone tumors in the pediatric and adolescent patient population. Biological reconstruction using a free, vascularized fibular graft is a well-established surgical technique. A ... Full text Link to item Cite

Role of mitogen-activated protein kinase in osteoblast differentiation.

Journal Article J Orthop Res · February 2011 Local control of osteoblast differentiation and bone formation is not well understood. We have previously seen biphasic effects on cell differentiation in response to the short- and long-term exposure to IL-1β in rat calvarial osteoblasts. To characterize ... Full text Link to item Cite

Dissecting molecular mechanisms of metastasis in a primary mouse model of soft tissue sarcoma

Journal Article CLINICAL & EXPERIMENTAL METASTASIS · February 1, 2011 Link to item Cite

Case report: Neuropathic arthropathy of the hip as a sequela of undiagnosed tertiary syphilis.

Journal Article Clin Orthop Relat Res · November 2010 BACKGROUND: Neuropathic arthropathy is characterized by rapidly progressive bone destruction in the setting of impaired nociceptive and proprioceptive innervation to the involved joint. It is seen most commonly in the foot and ankle, secondary to periphera ... Full text Link to item Cite

Extremity soft tissue sarcomas presented as hematomas.

Journal Article Arch Orthop Trauma Surg · October 2010 INTRODUCTION: Soft tissue sarcoma (STS) with extensive intra-tumoral hemorrhage is an infrequently described entity, usually misdiagnosed as intra-muscular hematoma. The outcomes in this group of patients have not been previously described. MATERIALS AND M ... Full text Link to item Cite

Biphasic effects of interleukin-1beta on osteoblast differentiation in vitro.

Journal Article J Orthop Res · July 2010 A rat calvarial cell model of osteoblast differentiation using the formation of bone nodules in vitro as an endpoint was used to assess the effects of IL-1beta on osteoblast differentiation. Short-term treatment (2 days) with IL-1beta early in culture resu ... Full text Link to item Cite

Bone cancer.

Journal Article J Natl Compr Canc Netw · June 2010 Full text Link to item Cite

Free vascularized fibular graft reconstruction of large skeletal defects after tumor resection.

Journal Article Clin Orthop Relat Res · February 2010 UNLABELLED: Skeletal reconstruction of large tumor resection defects is challenging. Free vascularized fibular transfer offers the potential for rapid autograft incorporation in limbs compromised by adjuvant chemotherapy or radiation. We retrospectively re ... Full text Link to item Cite

Cross species genomic analysis identifies a mouse model as undifferentiated pleomorphic sarcoma/malignant fibrous histiocytoma.

Journal Article PLoS One · November 30, 2009 Undifferentiated pleomorphic sarcoma/Malignant Fibrous Histiocytoma (MFH) is one of the most common subtypes of human soft tissue sarcoma. Using cross species genomic analysis, we define a geneset from the LSL-Kras(G12D); Trp53(Flox/Flox) mouse model of so ... Full text Link to item Cite

Cortical desmoid and the four clinical scenarios.

Journal Article Arch Orthop Trauma Surg · June 2009 We reviewed four patients diagnosed with a cortical desmoid lesion at the distal posterior medial femur. Each case reflects a clinical scenario that can be present. Cortical desmoid is a benign, self-limited entity which occasionally can exhibit aggressive ... Full text Link to item Cite

The clinical management of chondrosarcoma.

Journal Article Curr Treat Options Oncol · April 2009 Chondrosarcomas (CHS) represent a heterogeneous group of disorders ranging from indolent, low-grade tumors to aggressive, high-grade forms. Surgical resection represents the primary and preferred treatment modality for individuals with localized disease. R ... Full text Link to item Cite

Acral myxoinflammatory fibroblastic sarcomas: MRI findings in four cases.

Journal Article AJR Am J Roentgenol · May 2007 OBJECTIVE: Acral myxoinflammatory fibroblastic sarcoma is a rare, recently described, low-grade sarcoma that involves mainly the distal extremities. The purpose of this study is to report the MRI findings in four cases of acral myxoinflammatory fibroblasti ... Full text Link to item Cite

Bone cancer.

Journal Article J Natl Compr Canc Netw · April 2007 Full text Link to item Cite

Case reports: acral myxoinflammatory fibroblastic sarcoma: a report of five cases and literature review.

Journal Article Clin Orthop Relat Res · April 2006 During the past 2 years, we treated five patients with acral myxoinflammatory fibroblastic sarcoma at our institution. Four patients presented with a firm, painless mass in the hand that appeared over several months. One patient discovered a painless mass ... Full text Link to item Cite

Upper extremity compartmental anatomy: clinical relevance to radiologists.

Journal Article Skeletal Radiol · April 2006 Malignant tumors of the upper extremity are uncommon, and their care should be referred to specialized facilities with experience treating these lesions. The Musculoskeletal Tumor Society (MSTS) staging system is used by the surgeon to determine appropriat ... Full text Link to item Cite

Stacking of a dermal regeneration template for reconstruction of a soft-tissue defect after tumor excision from the palm of the hand: a case report.

Journal Article J Hand Surg Am · November 2005 Excision of tumors from the hand often leaves tissue defects with exposed tendons or neurovascular structures that require coverage. Various types of free and pedicled grafts have been described for use in these situations. We present a patient who had a t ... Full text Link to item Cite

Bone cancer clinical practice guidelines.

Journal Article J Natl Compr Canc Netw · March 2005 Link to item Cite

Malignant giant cell tumor of soft parts.

Journal Article Skeletal Radiol · May 2004 Giant cell tumor of soft parts (GCTSP) is an extremely rare lesion with an unpredictable behavior. Some patients are cured with a simple surgical excision whereas others will develop metastatic disease within a relatively short interval. To date, there are ... Full text Link to item Cite

Allografts about the Knee in Young Patients with High-Grade Sarcoma.

Journal Article Clin Orthop Relat Res · April 2004 Reconstruction after resections for high-grade sarcomas about the knee in children and adolescents is a challenging problem because of the large soft tissue and skeletal defects, the effects of adjuvant therapy, and the potential for long-term use of the l ... Full text Link to item Cite

Rotationplasty after failed limb-sparing tumor surgery: a report of two cases.

Journal Article Clin Orthop Relat Res · October 2003 Rotationplasty was used in two cases of failed limb salvage in adults after tumor resection and reconstruction. Each patient had distal femoral osteosarcoma, one treated with osteoarticular allograft reconstruction, the other with a custom endoprosthetic r ... Full text Link to item Cite

Insulin-like growth factor-I is expressed by avian flexor tendon cells.

Journal Article J Orthop Res · July 2000 Cells in normal tendon are in a resting G0 state, performing maintenance functions. However, traumatic injury introduces growth factors such as platelet-derived growth factor and insulin-like growth factor from blood as well as activates endogenous growth ... Full text Link to item Cite

PDGF-BB, IGF-I and mechanical load stimulate DNA synthesis in avian tendon fibroblasts in vitro.

Journal Article J Biomech · December 1995 Resident cells in the surface epitenon and internal compartment of flexor tendons are subjected to cyclic mechanical load as muscle contracts to move limbs or digits. Tendons are largely tensile load bearing tissues and are highly matrix intensive with non ... Full text Link to item Cite

Mechanoreception at the cellular level: the detection, interpretation, and diversity of responses to mechanical signals.

Journal Article Biochem Cell Biol · 1995 Cells from diverse tissues detect mechanical load signals by similar mechanisms but respond differently. The diversity of responses reflects the genotype of the cell and the mechanical demands of the resident tissue. We hypothesize that cells maintain a ba ... Full text Link to item Cite

Fibronectin in the tendon-synovial complex: quantitation in vivo and in vitro by ELISA and relative mRNA levels by polymerase chain reaction and northern blot.

Journal Article J Orthop Res · March 1994 An enzyme-linked immunosorbent assay was used to quantitate fibronectin (Fn) levels in the outer synovia (epitenon) and internal fibrous portion (endotenon) of chicken flexor tendon and sheath. Primary cell cultures from these tissues and their secretions ... Full text Link to item Cite