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Background: Information about orthopedics diseases on the Internet has not been extensively assessed. Our purpose was to evaluate the quality of online information of osteosarcoma on current video-sharing platforms in mainland China., Method: TikTok and Bilibili were independently queried from June to July 2023 by four independent researchers using the Microsoft Edge web browser. Information about the videos and creators was recorded, and descriptive analyses were conducted., Results: After data extraction, a total of 95 videos were included, in which 43 videos were uploaded by certified doctors (45.3%), with 35 videos (36.8%) uploaded by certified orthopedic surgeons. Of the content of these videos, 78.9% were introduction ( n = 75), 64.2% were on professional knowledge ( n = 61), 28.4% were on treatment ( n = 27), while 5.3% were on surgical techniques ( n = 5). The mean DISCERN total score was 43.8 ± 13.4, and the mean JAMA score was 3.8 ± 0.3., Conclusions: Videos about osteosarcoma on current video-sharing platforms were extensive, but were not comprehensive and professional. Although current online videos have the potential to improve public awareness on osteosarcoma, due to their quality and content, were not assessed to be good sources for medical education., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: It is well known that cancers have a common feature that even if the environment is extremely poor in nutrients, they can still make good use of them to maintain viability as well as to produce new biomass, which is one of the reasons why tumor cells are powerfully less susceptible to senescence and death. The microenvironment has a profound impact on the senescence as well as the growth and development of tumor cells, and it is also the focus of scientists' research because it may even affect the discovery of the treatment and pathogenesis of cancer. And so the study of the microenvironment in the tumor cells is of great significance to the analysis of the tumor cells as well as to the impact of their senescence. Similarly, the microenvironment of osteosarcoma is also crucial for its impact, but to our knowledge, there is no bibliometric study that systematically analyzes and describes the trends and future hotspots in this field of research as we do, and we are going to fill this gap in this study., Methods: We searched the Web Science Core Collection 2010-2023 in WOS on August 1, 2023. Based on the criteria needed for the search, we retained articles that matched the topic, excluded studies other than articles and reviews, and selected only studies whose language was English. We performed an intuitive visualization and bibliometric approach to analyze the research content in this field and a systematic visualization of global trends and hotspots in the research of osteosarcoma and the microenvironment, for which we used multiple specialized For this purpose, we used several specialized software packages, such as VOSviewer and the Bibliometrix package for R software. Because research in this area of osteosarcoma and the microenvironment has begun to gain popularity in the last 10 years or so, and is a very novel piece of research, there were almost no studies in this area prior to 2010 and they were not very informative, and in the end, we chose to look at studies from after 2010., Results: Based on the criteria needed for the search, resulting in a final selection of 821 articles. In the research area related to osteosarcoma and microenvironment, we found that China in Asia and the United States in North America and Italy in Europe were the three countries or regions with the highest number of published articles. In addition, the institution that published the most research in this area was Shanghai Jiao Tong University. In terms of publications in the field of osteosarcoma and microenvironmental research, Baldini, Heymann, and Avnet are among the top 3 authors. The terms "cancer", "cells" and "expression" are found to be more commonly employed., Conclusion: Using a variety of highly specialized software, we have undertaken a visual and bibliometric study of the current state of research and potential future hotspots in the field of osteosarcoma and microenvironment research. The microenvironment has a profound impact on the senescence and growth and development of cells in tumors, including osteosarcoma, and may even influence the discovery of cancer treatment and pathogenesis, and is also a hotspot and focus that scientists have begun to gradually study in recent years. This analysis and visualization will help guide future research in the field., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zhang and Shao.)

Chondrosarcoma is the second most common primary bone malignancy with the highest incidence in middle-aged and elderly people, where distant metastasis (DM) still leads to poor prognosis. The purpose of this study was to construct a nomogram for studying the diagnosis of DM in middle-aged and elderly patients with chondrosarcoma. Data on chondrosarcoma patients aged ≥ 40 years diagnosed from 2004 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The data were divided into a training set and an internal validation set according to a 7:3 ratio, and the training set data were screened for independent risk factors for DM in chondrosarcoma patients using univariate and multivariate logistic regression analysis. The screened independent risk factors were then used to build a nomogram. In addition, data from 144 patients with chondrosarcoma aged ≥ 40 years diagnosed in a tertiary hospital in China from 2012 to 2021 were collected as the external validation set. The results were evaluated by receiver operating characteristic curves, calibration curves, and decision curve analysis in the training set, internal validation set, and external validation set. A total of 1462 middle-aged and elderly patients with chondrosarcoma were included, and 92 (6.29%) had DM at the time of diagnosis. Independent risk factors for DM in middle-aged and elderly patients with chondrosarcoma included being married (OR: 2.119, 95% CI: 1.094-4.105), histological type of dedifferentiated chondrosarcoma (OR: 1.290, 95% CI: 1.110-1.499), high-grade tumor (OR: 1.511, 95% CI: 1.079-2.115), T3 stage (OR: 4.184, 95% CI: 1.977- 8.858), and N1 staging (OR: 5.666, 95% CI: 1.964-16.342). The area under the receiver operating characteristic curve (AUC) was 0.857, 0.820, and 0.859 in the training set, internal validation set, and external validation set, respectively. The results of the calibration curve and decision curve analysis also confirmed that the established nomogram could accurately predict DM in middle-aged and elderly patients with chondrosarcoma. Married, histological type of dedifferentiated chondrosarcoma, high-grade tumor, T3 stage, and N1 stage are independent risk factors for DM in middle-aged and elderly chondrosarcoma patients, and clinicians should see more attention., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

This study aimed to investigate the value of the product of peripheral blood platelet and serum C-reactive protein (P-CRP), an inflammatory indicator, for the prognosis of patients with osteosarcoma. Patients with osteosarcoma who were diagnosed and treated at the First Affiliated Hospital of Guangxi Medical University, China, between January 2012 and December 2019 were included in this retrospective study. Receiver operating characteristic curves were used to calculate the optimal cut-off values for inflammatory indicators such as P-CRP, the C-reactive protein/albumin ratio (CRP/Alb), the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) in the peripheral blood of patients before treatment. Based on the cut-off values, the patients were divided into high P-CRP and low P-CRP groups, high CRP/Alb and low CRP/Alb groups, high NLR and low NLR groups, and high NLR and low NLR groups; the Kaplan-Meier method was used to compare the overall survival (OS) rates and OS times of the above groups. Univariate and multivariate Cox regression models were used to analyze the effects of various factors on the prognosis of osteosarcoma and to determine the independent influencing factors. The Kaplan-Meier survival analysis results suggested that the OS rate of the high P-CRP group was significantly lower than that of the low P-CRP group (14.0% vs 67.2%, P < .001). The univariate analysis results suggested that tumor volume, tumor stage, NLR, PLR, P-CRP and CRP/Alb were factors that affected the prognosis of patients with osteosarcoma, and the differences were statistically significant (P < .05). The multivariate analysis results showed that tumor volume (hazard ratio [HR] = 1.061; 95% CI, 1.001-1.125; P = .046) and preoperative P-CRP (HR, 1.037; 95% CI, 1.024-1.050; P < .01) were independent prognostic factors affecting the OS rate after osteosarcoma surgery. The results of our study showed that P-CRP is a novel and promising prognostic indicator for patients with osteosarcoma. The higher the P-CRP level in the peripheral blood of patients is before treatment, the worse the prognosis might be., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: To assess the predictive value of the tumor staging system in the AJCC Cancer Staging Manual, Eighth Edition, and histologic features for outcomes and metastasis patterns in conjunctival melanoma (CM)., Design: Retrospective, single-center cohort study., Participants: Eighty-three patients with CM were treated at Shanghai Ninth People's Hospital between 2000 and 2021., Methods: We reviewed the clinical and histologic parameters and used Kaplan-Meier survival curves and Cox proportional hazards regression models for risk factor analyses., Main Outcome Measures: Time to nodal/distant metastasis, disease-specific survival, metastatic pattern, and metastatic site., Results: At presentation, 5 patients (6%) had clinical tumor (cT)1 disease, 34 patients (41%) had cT2 disease, and 44 patients (53%) had cT3 disease. Four patients (5%) had nodal metastasis (N1), and none had distant metastasis (M1). During follow-up, 12 patients (14%) developed nodal metastasis, 29 patients (35%) developed distant metastasis, and 26 patients (31%) died of disease. The brain, liver, and lung were common distant metastasis sites. Higher cT category was associated with increased risks of distant metastasis (P < 0.001) and disease-specific death (P = 0.002). The separate analysis of primary and recurrent tumors at presentation showed that the patients with cT3 tumors had a higher risk of distant metastasis than those with cT2 tumors. Greater tumor thickness, ulceration, and the presence of regression were correlated with distant metastasis. Previously unreported mutations were detected in the tumor suppressor genes FAT atypical cadherin 4 (FAT4) and spleen associated tyrosine kinase (SYK). Among the 29 patients who developed distant metastasis, we analyzed 2 patterns of metastasis: Eleven patients (38%) developed nodal metastasis before distant metastasis, and 18 patients (62%) developed distant metastasis without previously known nodal metastasis. The patients with cT3 tumors were more likely to follow the latter metastasis pattern (P = 0.02)., Conclusions: Conjunctival melanoma presented with mostly advanced stages and high rates of distant metastasis in the current Chinese cohort. This study confirmed the prognostic value of the tumor staging system in the AJCC Cancer Staging Manual, Eighth Edition, for Chinese patients. Histologic features, such as tumor thickness and ulceration, should be emphasized when assessing prognosis and guiding the treatment of CM., (Copyright © 2022 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Introduction: Withholding the malignant bone tumors disclosure from patients is common in China. The purpose of the study was to explore the perceptions of patients, families, doctors, and nurses regarding the disclosure of malignant bone tumors in China., Method: Semistructured interviews were conducted with 25 cases, consisting of 69 participants (14 patients, 25 family members, 17 doctors, and 13 nurses), and the transcripts were analysed using Colaizzi's (1978) descriptive phenomenological analysis process., Results: Five themes were identified: (1) doctors preferred to inform the family members first, (2) family members' decisions depended on different situations, (3) the patients agreed that disclosure should be different for each person/personally, (4) care from nurses reduced the overreaction of patients, and (5) key points improve the informing quality., Discussion: Family participatory cancer disclosure and multidisciplinary teams could improve the quality of cancer disclosure. Culturally congruent health care and culturally sensitive interventions in cancer disclosure are suggested.

Rothmund-Thomson syndrome (RTS) is a rare autosomal-recessive disorder characterized by poikiloderma, short stature, sparse hair, skeletal abnormalities, and cancer predisposition. Mutations in ANAPC1 or RECQL4 have been identified to underlie RTS. Either Sanger sequencing or next-generation sequencing (NGS) was performed for three Chinese RTS patients. Copy number variants were called by the eXome-Hidden Markov Model using read-depth data of NGS, and the putative heterozygous deletion was confirmed by PCR with multiple primers. The breakpoints were identified by Sanger sequencing. All patients presented with characteristic features of poikiloderma, short stature, and sparse hair, eyelashes, and eyebrows. In addition, patient 1 had intellectual disability and speech delay, and patient 2 developed osteosarcoma when she was 13 years old. Biallelic RECQL4 variants were identified in all three patients. Five of the six variants were novel, including c.119-1G>A, c.2886-1G>A, c.2290C>T (p.Gln764*), and c.3552dupG (p.Arg1185Glufs*42), and a gross deletion encompassing exons 6 to 10. Our study expands the genetic and clinical spectrums of RTS. Furthermore, we reported the first heterozygous gross deletion in RECQL4., (© 2021 Japanese Dermatological Association.)

Purpose: We evaluated the stability of orthognathic surgery in the treatment of unilateral condylar osteochondroma combined with jaw deformity., Patients and Methods: Patients with unilateral condylar osteochondroma and jaw deviation deformity who had undergone surgery at the Ninth People's Hospital of Shanghai Jiaotong University School of Medicine from July 2014 to March 2017 were enrolled. The operation included a low condylectomy and both Le Fort I osteotomy and bilateral mandibular sagittal split osteotomies. ProPlan CMF, version 1.4, software (Materialise, Leuven, Belgium) was used to reconstruct and measure the preoperative, immediately postoperative, and follow-up (>6 months) maxillofacial computed tomography images. The position of the jaw and contralateral condyle and remodeling of the affected side were compared during follow-up., Results: Eight patients were included in the present study. The canting of the maxilla was significantly decreased postoperatively, and the contralateral condyle had rotated inward. The position of the maxillary and contralateral condyles was stable during follow-up, and the posterior aspect of the affected condyle demonstrated significant resorption., Conclusions: The results of single-stage surgery combined with orthognathic surgery and condylar osteochondroma resection were stable, and the affected condyle stump had adaptively reconstructed., (Copyright © 2020 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Bone is the second most common metastatic site of renal cell carcinoma (RCC), about 35-40% of metastatic RCC patients are associated with bone metastasis. Bone metastasis can cause pain, pathological fracture, spinal cord compression, hypercalcemia and other skeletal related events (SREs), which may seriously affect patients' quality of life. RCC patients with bone metastasis, for whom drug therapy alone is less effective and the prognosis is poor, required multi-disciplinary team (MDT) and individualized comprehensive treatment to reduce or delay the onset of SRE, to maintain the quality of life and to extend the time of disease control and survival. In order to update the worldwide treatment progress in RCC with bone metastasis timely, and to improve the standardized diagnosis and treatment of such patients in China, the diagnosis and therapy for bone metastasis of malignant tumor and skeletal-related event expert group formulates "Expert consensus on renal cell carcinoma with bone metastasis (2020 Edition)" .

The specialty of bone cancer has developed rapidly in China in recent years, but because of the low incidence of these diseases and the unbalanced development of different regions, the malpractice problem of diagnosis and treatment is still outstanding.The NCCN clinical practice guide for bone cancer in the United States has been updated for several years and is now more mature and has been recognized worldwide.It can provide reference for medical professionals in related fields in China, it covers the most common bone tumors such as osteosarcoma, Ewing's sarcoma, chondrosarcoma, giant cell tumor of bone and chordoma.This article describes and interprets the core diagnostic and therapeutic contents of NCCN clinical practice guide for bone cancers.

Background: The effectiveness of local surgery for bone metastases (BM) arising from renal cell carcinoma (RCC) remains uncertain. Herein, the authors performed what to the best of their knowledge is the first investigation of the outcomes of Chinese patients with RCC and BM., Methods: Data were collected for 168 patients with RCC and BM who were treated at Changzheng Hospital in Shanghai, China, between March 2009 and December 2018. All patients underwent local surgery for BM arising from RCC. Overall survival (OS) was defined as the interval between the date of local surgery and death or last follow-up and was estimated using the Kaplan-Meier method. Univariate and multivariable Cox proportional hazards analyses were used to identify significant prognostic factors., Results: The median OS in the study cohort was 43 months (range, 0-113 months). The 1-year, 3-year, and 5-year survival rates after surgery were 77.4%, 55.9%, and 31.8%, respectively. Univariate analyses demonstrated significant survival differences associated with sex (P = .003), the number of preoperative metastatic sites (BM alone or BM with concomitant metastasis; P < .001), and the number of BM (single or multiple; P = .008). OS also did not appear to differ regardless of whether the patients received postsurgical targeted therapy. Multivariable Cox regression demonstrated that the following characteristics were independent predictors of OS: the number of preoperative metastatic sites, International Metastatic Renal Cell Carcinoma Database Consortium risk score, and Memorial Sloan Kettering Cancer Center score., Conclusions: Careful patient selection for local surgery is of paramount importance. The prognoses of patients in the Memorial Sloan Kettering Cancer Center-based and International Metastatic Renal Cell Carcinoma Database Consortium-based poor-risk groups were much worse than those of the intermediate-risk groups. In current clinical practice, "stratified treatment" can be performed according to these criteria., (© 2020 American Cancer Society.)

Objective: To investigate the diagnostic role of H3F3A G34W immunohistochemistry in giant cell tumor of bone. Methods: A total of 275 tumors were collected from 2016 to 2018 at Shanghai Jiaotong University Affiliated Sixth People's Hospital, including 136 giant cell tumors of bone, 31 general osteosarcomas, 3 osteoclast-rich osteosarcomas, 3 brown tumors, 34 chondroblastomas, 29 giant cell tumors of tendon sheath, 20 primary arteromatoid bone cysts and 19 non-ossifying fibromas. Results: Among the 136 cases of giant cell tumor of bone,82 patients were male and 54 were female. The age ranged from 15 to 72 years (median age 38 years). Nuclear positivity for H3F3A G34W was seen in 119/136(87.5%) giant cell tumors of bone and 1/31(3.2%) general osteosarcoma,while all osteoclast-rich osteosarcomas, brown tumors, chondroblastomas, giant cell tumors of tendon sheath, primary arteromatoid bone cysts and non-ossifying fibroma were negative. Conclusions: The monoclonal antibody against the G34W mutated site of H3F3A is a specific biomarker for giant cell tumor of bone and useful for the diagnosis and differential diagnosis of giant cell tumor of bone. Meanwhile,for those cases in which giant cell tumor of bone are diagnosed basing on clinical,pathologic and radiographic features but are negative for H3F3A G34W,should be tested for rare mutations or H3F3A wild type.

Programmed death receptor 1 (PD-1) and its ligand PD-L1 have been shown to play an important role in evading the immune system. In recent years, PD-1/PD-L1 blockade has shown significant clinical effects in many malignancies, including malignant melanoma, renal cell carcinoma, classic Hodgkin lymphoma, non-small cell lung cancer and so on. PD-1/PD-L1 signaling pathway has become a new target of immunotherapy in patients with malignant tumors. However, there are few researches on immunotherapy in malignant bone tumors, and the progress of clinical research on PD-1/PD-L1 remains to be elucidated. This review started from the mechanism of PD-1/PD-L1 signaling in tumor immunity, and analyzed the application prospect of PD-1/PD-L1 antibodies in malignant bone tumors. We hope to provide a theoretical basis for the treatment of malignant bone tumors based on PD-1/PD-L1 signaling pathway in China.

With the rapid development of modern medicine, significant stride has been achieved in the field of bone and soft tissue tumor in China.The early efforts in the treatment of bone tumor led to the foundation of Bone Tumor Group of Chinese Medical Association in 1985, which marked the initial formation of standardized diagnosis and treatment of bone tumor.Since then, the guidelines of diagnosis and treatment of bone tumor were widely spread and obeyed. The gradually evolution of limb-salvage technique, the improved en-bloc resection procedure in spine and pelvis tumor,the effective bleeding control measure have made concrete basis for higher survival rate, better functional status and life quality for patients than before. With new breakthroughs in the field of molecular biology and immunology, the development in stereotactic radiation and combination of new material and mega-data with medicine, the treatment of bone tumor is entering a new era of precision and personalized medicine.

OBJECTIVE. To report a series of patients with Paget's disease of bone that is rarely diagnosed in the Chinese, and to describe their presentations and clinical characteristics. DESIGN. A retrospective case series and literature review. SETTING. A regional public hospital in Hong Kong. PATIENTS. Patients with a diagnosis of Paget's disease of bone (or osteitis deformans) documented in the Clinical Management System of the Hospital Authority and being followed up in the medical endocrine clinic of the Pamela Youde Nethersole Eastern Hospital were identified in July 2011. This was performed using the Clinical Data Analysis and Reporting System of the Hospital Authority. Corresponding case notes and radiological imaging data were retrieved and reviewed. Patients with diagnostic X-ray or computed tomography findings of Paget's disease of bone were included in this series. The demographic data, clinical features, and investigation results of the cases were retrieved, recorded, and analysed. RESULTS. Seven Chinese patients (5 men and 2 women; mean age, 66 years) diagnosed to have Paget's disease of bone from 2000 to 2010 were identified. All but one were asymptomatic and presented as an incidental finding (isolated raised serum alkaline phosphatase level or abnormal X-ray). The most commonly involved sites were the skull and pelvis. The majority (71%) of the patients had polyostotic disease. During follow-up, there were no disease-related complications, nor was malignant transformation identified. None reported positive family history. CONCLUSION. In this series of seven Chinese patients with Paget's disease, most were asymptomatic and presented with an isolated raised serum alkaline phosphatase level during routine testing. The disease was predominantly found in males and the elderly, and commonly involved the skull and pelvis.