Annual Report 2017
Department of Musculoskeletal Oncology and Rehabilitation
Akira Kawai, Fumihiko Nakatani, Eisuke Kobayashi, Shintaro Iwata, Tomoaki Iwata, Junya Ueno, Miki Fujii, Yoshie Ino, Noriatsu Tatematsu, Yu Koishiwara
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 four 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 two days a week (Mondays and Wednesdays) 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 with by other cancer specialists on daily basis. To provide prosthetic and orthotic care for our patients, a special outpatient service is open on every Friday. In cases with patients who need multidisciplinary approaches to their treatments, we offer appropriate referrals to the NCCH for further treatments. In September 2014, we opened a spacious rehabilitation unit with state-of-the-art equipment with an 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 1,917 patients in 2017 and 444 patients from January 1st to March 31st of 2018 (Table 1).
Table 1. Characteristics and number of patients enrolled for rehabilitation
Research activities
We have been focusing on regional cooperation with local physiotherapists of Kashiwa-city with an aim to provide cancer patients of the community with seamless rehabilitation care after invasive cancer operations. Until now, we have established the standard methods of physiotherapy and functional evaluations in common.
Clinical trials
We have also been focusing on the standardization of adjuvant and second-line chemotherapy regimens for bone and soft tissue sarcomas. Several multi-institutional clinical trials were conducted as follows:
1) A multi-institutional phase III clinical trial of multi-drugs adjuvant chemotherapy for osteosarcomas (The Japan Clinical Oncology Group (JCOG) 0905) since 2010
2) A multi-institutional phase III clinical trial of multi-drugs adjuvant chemotherapy for osteosarcomas (JCOG 1306) since 2014
3) A multi-institutional phase III clinical trial of preoperative denosumab for giant cell tumor (JCOG 1610) since 2017
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 the 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 January 2017 - March 2018
Journal
1. Akiyama T, Uehara K, Ogura K, Shinoda Y, Iwata S, Saita K, Tanzawa Y, Nakatani F, Yonemoto T, Kawano H, Davis AM, Kawai A. Cross-cultural adaptation and validation of the Japanese version of the Toronto Extremity Salvage Score (TESS) for patients with malignant musculoskeletal tumors in the upper extremities. J Orthop Sci, 22:127-132, 2017
2. Miyamoto S, Fujiki M, Nakatani F, Kobayashi E, Sakisaka M, Sakuraba M. Reconstruction of Complex Groin Defects After Sarcoma Resection. Ann Plast Surg, 78:443-447, 2017