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Tumor Progression02:07

Tumor Progression

Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
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Every normal cell or tissue is embedded in a complex local environment called stroma, consisting of different cell types, a basal membrane, and blood vessels. As normal cells mutate and develop into cancer cells, their local environment also changes to allow cancer progression. The tumor microenvironment (TME) consists of a complex cellular matrix of stromal cells and the developing tumor. The cross-talk between cancer cells and surrounding stromal cells is critical to disrupt normal tissue...
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Tumor Progression02:07

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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
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Taper Junction Subsidence Occurs in Modular Tumor Endoprostheses: How Concerned Should We Be?

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Taper subsidence is a significant complication in modular femoral tumor endoprostheses, affecting 14% of distal femur replacements. Further research is needed to understand the impact of this late, progressive damage on patient outcomes and metal ion levels.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Oncologic Reconstruction

Background:

  • Longer survival in bone tumor patients increases reliance on tumor endoprostheses.
  • Modular implants risk taper junction corrosion and subsidence, releasing metal particles.
  • Source of increased serum ions (corrosion vs. implant) and taper subsidence remain unclear.

Purpose of the Study:

  • Determine survivorship free from radiographic taper junction subsidence in femoral modular tumor endoprostheses.
  • Identify implant characteristics associated with taper subsidence.

Main Methods:

  • Retrospective analysis of 84 distal/proximal femur replacements (1996-2020).
  • Radiographic evaluation for taper junction subsidence.
  • Regression analysis of factors like number of junctions and resection length.

Main Results:

  • 14% of distal femur replacements showed taper subsidence.
  • 10-year survivorship free from subsidence was 91%; 20-year was 84%.
  • Subsidence was progressive, often involved multiple junctions, and was not linked to studied risk factors.

Conclusions:

  • Taper damage with late, progressive subsidence is common after distal femur replacement.
  • The clinical impact of taper subsidence remains unknown.
  • Further studies should investigate long-term outcomes and metal ion correlations.