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Department of Musculoskeletal Oncology and Rehabilitation

Hirokazu Chuuman, Akira Kawai, Fumihiko Nakatani, Yoshikazu Tanzawa, Eisuke Kobayashi, Makoto Endo, Junya Ueno, Miki Fujii, Yoshie Ino, Noriatsu Tatematsu, Yu Koishihara

Introduction

The Department of Musculoskeletal Oncology and Rehabilitation of the National Cancer Center Hospital East (NCCHE) is a team consisting of a panel of orthopedic surgeons and rehabilitation professionals that started from 2012. We strive to provide expert interdisciplinary care for a variety of benign and malignant bone and soft tissue tumors and tumor-like conditions, and we also provide comprehensive rehabilitation services. Currently, we have six orthopedic surgeons and five rehabilitation staff engaging in the treatment for a variety of patients with the aid of other orthopedic staff from the National Cancer Center Hospital (NCCH).

Our team and what we do

Our outpatient service is open three days a week (Mondays, Wednesdays, and Fridays) for patients with a variety of musculoskeletal tumors or cancer patients who need rehabilitation care. We also manage patients with bone metastases or other orthopedic diseases, consulted from other cancer specialists on daily basis. To provide the prosthetic and orthotic care for our patients, a special outpatient service is open every Friday. In cases with patients who need multidisciplinary approaches to their treatments, we offer appropriate referral to the NCCH for further treatments.

In 2016, we conducted 18 operations in total, consisted of 10 resections of soft tissue tumors, two osteosyntheses of pathological fractures form bone metastases, five operations for bone tumors and one operation for other tumors/reasons.

In September 2014, we opened a spacious rehabilitation unit with state-of-the-art equipment with the aim to reduce the common side effects of cancer treatment, including fatigue, weakness, poor endurance, pain, nausea, anxiety, depression, and loss of confidence. As a result, we conducted rehabilitation for 1,321 patients in 2016 (Table 1).

Table 1. Characteristics and number of patients enrolled for rehabilitation

Table 1. Characteristics and number of patients enrolled for rehabilitation
Table 1. Characteristics and number of patients enrolled for rehabilitation(Full Size)

Research activities

We have been focusing on regional cooperation with local physiotherapists of Kashiwa City with the aim to provide cancer patients of the community with seamless rehabilitation care after the invasive cancer operations. Until now, we have established the standard methods of physiotherapy and functional evaluations in common.

Clinical trials

We have been focusing on the standardization of multidisciplinary treatment for bone and soft tissue sarcomas through cooperation with the Department of Musculoskeletal Oncology and Rehabilitation of the NCCH. Two multiinstitutional clinical trials are active as follows:

1)A multiinstitutional phase III clinical trial of multidrug adjuvant chemotherapy for osteosarcoma (JCOG 0905) has been ongoing since 2010.

2)A multiinstitutional phase III clinical trial of adjuvant chemotherapy for high-grade soft part sarcoma (JCOG 1306) started in February 2014.

Education

We have undertaken several educational lectures for the medical staff to highlight the importance of rehabilitation for cancer treatment. We also provide some instructive lectures for the medical staff of the community.

Future prospects

Recent evolution of cancer treatment increases the demand for orthopedic care and rehabilitation of cancer survivors. We must consistently focus on standardization for the methodology of rehabilitation for all cancer patients, which will be beneficial for the augmentation of quality of life for these patients.

List of papers published in 2016

Journal

1.Yasui N, Yoshida A, Kobayashi E, Nakatani F, Kawamoto H. Successful Treatment of Extra-Renal Noncerebral Rhabdoid Tumors with VIDE. Pediatr Blood Cancer, 63:352-354, 2016

2.Maekawa A, Kohashi K, Kuda M, Iura K, Ishii T, Endo M, Nakatsura T, Iwamoto Y, Oda Y. Prognostic significance of FOXM1 expression and antitumor effect of FOXM1 inhibition in synovial sarcomas. BMC Cancer, 16:511, 2016

3.Hirahata M, Osaki M, Kanda Y, Sugimoto Y, Yoshioka Y, Kosaka N, Takeshita F, Fujiwara T, Kawai A, Ito H, Ochiya T, Okada F. PAI-1, a target gene of miR-143, regulates invasion and metastasis by upregulating MMP-13 expression of human osteosarcoma. Cancer Med, 5:892-902, 2016

4.Pan X, Yoshida A, Kawai A, Kondo T. Current status of publicly available sarcoma cell lines for use in proteomic studies. Expert Rev Proteomics, 13:227-240, 2016

5.Bekki H, Fukushi J, Mizu-uchi H, Endo M, Oda Y, Iwamoto Y. Fibromatosis of the soleus muscle presenting as pes equinus: a case report. Foot Ankle Online J, 9:4, 2016

6.Matsunobu T, Bekki H, Harimaya K, Matsumoto Y, Endo M, Yoshitake K, Oda Y, Iwamoto Y. Osteosarcoma of the middle and distal phalanges of the little toe with a cancerous ulcer. Int J Case Rep Images, 7:185-189, 2016

7.Tahara K, Yamashita K, Hiwatashi A, Togao O, Kikuchi K, Endo M, Otsuka H, Oda Y, Honda H. MR Imaging Findings of a Leiomyosarcoma of the Thoracic Spine: A Case Report. Clin Neuroradiol, 26:229-233, 2016

8.Araki N, Takahashi S, Sugiura H, Ueda T, Yonemoto T, Takahashi M, Morioka H, Hiraga H, Hiruma T, Kunisada T, Matsumine A, Kawai A. Retrospective inter- and intra-patient evaluation of trabectedin after best supportive care for patients with advanced translocation-related sarcoma after failure of standard chemotherapy. Eur J Cancer, 56:122-130, 2016

9.Fujiki M, Miyamoto S, Kobayashi E, Sakuraba M, Chuman H. Early detection of local recurrence after soft tissue sarcoma resection and flap reconstruction. Int Orthop, 40:1975-1980, 2016

10.Iwata S, Uehara K, Ogura K, Akiyama T, Shinoda Y, Yonemoto T, Kawai A. Reliability and Validity of a Japanese-language and Culturally Adapted Version of the Musculoskeletal Tumor Society Scoring System for the Lower Extremity. Clin Orthop Relat Res, 474:2044-2052, 2016

11.Kato I, Yoshida A, Ikegami M, Okuma T, Tonooka A, Horiguchi S, Funata N, Kawai A, Goto T, Hishima T, Aoki I, Motoi T. FOSL1 immunohistochemistry clarifies the distinction between desmoplastic fibroblastoma and fibroma of tendon sheath. Histopathology, 69:1012-1020, 2016

12.Kawai A, Araki N, Hiraga H, Sugiura H, Matsumine A, Ozaki T, Ueda T, Ishii T, Esaki T, Machida M, Fukasawa N. A randomized, double-blind, placebo-controlled, Phase III study of pazopanib in patients with soft tissue sarcoma: results from the Japanese subgroup. Jpn J Clin Oncol, 46:248-253, 2016

13.Kimura H, Yamamoto N, Shirai T, Nishida H, Hayashi K, Tanzawa Y, Takeuchi A, Miwa S, Tsuchiya H. Clinical Outcome of Reconstruction Using Frozen Autograft for a Humeral Bone Tumor. Anticancer Res, 36:6631-6635, 2016

14.Kim Y, Kobayashi E, Kubota D, Suehara Y, Mukaihara K, Akaike K, Ito A, Kaneko K, Chuman H, Kawai A, Kitano S. Reduced argininosuccinate synthetase expression in refractory sarcomas: Impacts on therapeutic potential and drug resistance. Oncotarget, 7:70832-70844, 2016

15.Miyamoto S, Arikawa M, Fujiki M, Kawai A, Kobayashi E, Sakuraba M. The Superior Rectal Artery as a Recipient Vessel for Free Flap Transfer After Partial Sacrectomy in Patients With Chordoma. Ann Plast Surg, 76:315-317, 2016

16.Miyamoto S, Fujiki M, Sakisaka M, Kawai A. Combined Use of the Latissimus Dorsi Musculocutaneous Flap and the Anterolateral Thigh Flap to Reconstruct an Extensive Shoulder Defect in an NF-1 Patient. Plast Reconstr Surg Glob Open, 4:e670, 2016

17.Miyamoto S, Fujiki M, Setsu N, Kawai A. Simultaneous reconstruction of the bone and vessels for complex femoral defect. World J Surg Oncol, 14:291, 2016

18.Miyamoto S, Kagaya Y, Arikawa M, Kobayashi E. Combined Use of an Anterolateral Thigh Flap and Superficial Inferior Epigastric Artery Flap for Reconstruction of an Extensive Abdominal Wall Defect. Plast Reconstr Surg Glob Open, 4:e1121, 2016

19.Mori T, Nakayama R, Endo M, Hiraga H, Tomita M, Fukase N, Kobayashi E, Kawai A, Ueda T, Morioka H. Forty-eight cases of leiomyosarcoma of bone in Japan: A multicenter study from the Japanese musculoskeletal oncology group. J Surg Oncol, 114:495-500, 2016

20.Morioka H, Takahashi S, Araki N, Sugiura H, Ueda T, Takahashi M, Yonemoto T, Hiraga H, Hiruma T, Kunisada T, Matsumine A, Susa M, Nakayama R, Nishimoto K, Kikuta K, Horiuchi K, Kawai A. Results of sub-analysis of a phase 2 study on trabectedin treatment for extraskeletal myxoid chondrosarcoma and mesenchymal chondrosarcoma. BMC Cancer, 16:479, 2016

21.Yoshida A, Goto K, Kodaira M, Kobayashi E, Kawamoto H, Mori T, Yoshimoto S, Endo O, Kodama N, Kushima R, Hiraoka N, Motoi T, Kawai A. CIC-rearranged Sarcomas: A Study of 20 Cases and Comparisons With Ewing Sarcomas. Am J Surg Pathol, 40:313-323, 2016

22.Mukaihara K, Suehara Y, Kohsaka S, Kubota D, Toda-Ishii M, Akaike K, Fujimura T, Kobayashi E, Yao T, Ladanyi M, Kaneko K, Saito T. Expression of F-actin-capping protein subunit beta, CAPZB, is associated with cell growth and motility in epithelioid sarcoma. BMC Cancer, 16:206, 2016

23.Setsu N, Kobayashi E, Asano N, Yasui N, Kawamoto H, Kawai A, Horiuchi K. Severe hypercalcemia following denosumab treatment in a juvenile patient. J Bone Miner Metab, 34:118-122, 2016

24.Ito J, Asano N, Kawai A, Yoshida A. The diagnostic utility of reduced immunohistochemical expression of SMARCB1 in synovial sarcomas: a validation study. Hum Pathol, 47:32-37, 2016

25.Akiyama T, Saita K, Ogura K, Kawai A, Imanishi J, Yazawa Y, Kawashima N, Ogata T. The effect of an external hip joint stabiliser on gait function after surgery for tumours located around the circumference of the pelvis: analysis of seven cases of internal hemipelvectomy or proximal femur resection. Int Orthop, 40:561-567, 2016

26.Nakamura T, Matsumine A, Kawai A, Araki N, Goto T, Yonemoto T, Sugiura H, Nishida Y, Hiraga H, Honoki K, Yasuda T, Boku S, Sudo A, Ueda T. The clinical outcome of pazopanib treatment in Japanese patients with relapsed soft tissue sarcoma: A Japanese Musculoskeletal Oncology Group (JMOG) study. Cancer, 122:1408-1416, 2016

27.Nezu Y, Hagiwara K, Yamamoto Y, Fujiwara T, Matsuo K, Yoshida A, Kawai A, Saito T, Ochiya T. miR-135b, a key regulator of malignancy, is linked to poor prognosis in human myxoid liposarcoma. Oncogene, 35:6177-6188, 2016

28.Setsu N, Miyake M, Wakai S, Nakatani F, Kobayashi E, Chuman H, Hiraoka N, Kawai A, Yoshida A. Primary Retroperitoneal Myxoid Liposarcomas. Am J Surg Pathol, 40:1286-1290, 2016

29.Shibata H, Kato S, Sekine I, Abe K, Araki N, Iguchi H, Izumi T, Inaba Y, Osaka I, Kawai A, Kinuya S, Kodaira M, Kobayashi E, Kobayashi T, Sato J, Shinohara N, Takahashi S, Takamatsu Y, Takayama K, Tateishi U, Nagakura H, Hosaka M, Morioka H, Moriya T, Yuasa T, Yurikusa T, Yomiya K, Yoshida M. Diagnosis and treatment of bone metastasis: comprehensive guideline of the Japanese Society of Medical Oncology, Japanese Orthopedic Association, Japanese Urological Association, and Japanese Society for Radiation Oncology. ESMO Open, 1:e000037, 2016

30.Takeuchi A, Tsuchiya H, Ishii T, Nishida Y, Abe S, Matsumine A, Kawai A, Yoshimura K, Ueda T. Clinical outcome of recurrent giant cell tumor of the extremity in the era before molecular target therapy: the Japanese Musculoskeletal Oncology Group study. BMC Musculoskelet Disord, 17:306, 2016

31.Kubota D, Kosaka N, Fujiwara T, Yoshida A, Arai Y, Qiao Z, Takeshita F, Ochiya T, Kawai A, Kondo T. miR-125b and miR-100 Are Predictive Biomarkers of Response to Induction Chemotherapy in Osteosarcoma. Sarcoma, 2016:1390571, 2016