Noain, E. (E.)
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- Bone metastases from osteosarcoma(Springer Verlag, 2003) Noain, E. (E.); Diaz-de-Rada, P. (Pablo); Sierrasesumaga, L. (Luis); San-Julian, M. (Mikel)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.
- Limb salvage in bone sarcomas in patients younger than age 10. A 20-year experience.(Lippincott, Williams & Wilkins, 2003) Cañadell, J.M. (J. M.); Noain, E. (E.); Garcia-Barrecheguren, E. (E.); Sierrasesumaga, L. (Luis); San-Julian, M. (Mikel); Dolz, R. (Rodrigo)The authors present their experience over the last 20 years in limb salvage procedures of a consecutive series of 40 children under 10 years of age (range 2-10 years) with bone sarcomas. Nineteen were osteogenic sarcomas and 21 were Ewing sarcomas. Only one case, located in the distal phalanx of the toe, was treated by straightforward amputation. Intercalary allografts and Canadell's technique were used to preserve joints whenever possible, and prosthesis or osteoarticular allografts were used when the joint surface was involved. Survival rate in this series was 75%. There were four local recurrences. At the last follow-up (mean 11.2 years, range 5-19 years postop), 90% of the patients preserved their limbs. Eighty percent of the authors' results were excellent or good according to the Musculoskeletal Tumor Society Scale. Limb salvage is a real possibility even in young children with bone sarcomas. The age of the patient itself is not a contraindication for limb salvage.
- Tratamiento quirúrgico de las metástasis vertebrales(Universidad de Navarra, 1998) Noain, E. (E.); Beguiristain-Gurpide, J.L. (José Luis); Bascuñan, F. (F.); Arriagada, C. (C.); Villas-Tome, C. (Carlos)Las metástasis vertebrales causan dolor y déficit neurológico por la destrucción ósea y compresión medular. Las nuevas terapias oncológicas han prolongado la vida sobrevida de muchos pacientes afectos de tumores de distinto origen y el tratamiento de las metástasis es frecuentemente necesario para mejorar la calidad de vida. Se estudian 121 pacientes afectos de metástasis vertebrales de una variada etiología de tumores primarios, tratados quirúrgicamente entre 1982 y 1995; se utilizaron distintos abordajes e instrumentación según lo requiriera el caso, dependiendo de la localización y expectativa de vida; en ellos se analizaron aspectos como localización del tumor primario, dolor y afectación neurológica pre y post quirúrgicos, complicaciones y evolución. La estabilización quirúrgica junto a la descompresión de las metástasis vertebrales proporciona excelentes resultados en cuanto al alivio del dolor y recuperación del déficit en estos pacientes, mejorando la calidad de sobrevida y apoyando el tratamiento de la enfermedad tumoral