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Current Oncology
Special Issues
Advances in the Orthopaedic Oncology
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Advances in the Orthopaedic Oncology

A Special Issue of Current Oncology (ISSN 1718-7729) belonging to the section "Bone and Soft Tissue Oncology".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 2281

Editor

Dr. Hisaki Aiba

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, Nagoya City University, Nagoya 467-8601, Japan
Interests: pediatiric malignancy; sarcoma; bone tumor; surgery; chemotherapy

Special Issue Information

Dear Colleagues,

This Special Issue aims to present recent advances in the diagnosis and treatment of orthopedic oncology, including primary bone and soft-tissue sarcomas and metastatic bone disease. We welcome original research articles and reviews focusing on novel surgical techniques, limb-sparing approaches, reconstructive strategies, systemic therapies, radiation advances, biomarker-driven treatments, immunotherapy, and targeted therapies. Studies addressing translational research, clinical trials, tumor microenvironment, mechanisms of tumor progression and treatment resistance, and approaches to improve functional and quality-of-life outcomes are particularly encouraged. Through this Special Issue, we seek to provide a platform for sharing cutting-edge findings that can contribute to improved survival, functional preservation, and personalized care in orthopedic oncology.

Dr. Hisaki Aiba
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • limb sparing surgery
  • personalized surgery
  • mechanisms of tumor progression
  • radiotherapy
  • chemotherapy
  • immunotherapy
  • targeted therapy

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Published Papers (5 papers)

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Research

Jump to: Review, Other

18 pages, 1622 KB  
Article
Pathological and MRI-Based Infiltrative Markers Show Distinct Associations with Oncologic Outcomes in Undifferentiated Pleomorphic Sarcoma and Myxofibrosarcoma
by Akane Ariga, Yuki Funauchi, Kyoko Yamashita, Masanori Saito, Keiko Hayakawa, Taisuke Tanizawa, Norio Kurosawa, Toshitaka Yoshii and Keisuke Ae
Curr. Oncol. 2026, 33(10), 572; https://doi.org/10.3390/curroncol33100572 (registering DOI) - 22 Sep 2026
Abstract
Undifferentiated pleomorphic sarcoma (UPS) and myxofibrosarcoma (MFS) frequently exhibit infiltrative growth, but whether pathological and magnetic resonance imaging (MRI)-based findings represent the same tumor characteristics remain unclear. We examined the relationships among report-documented pathological infiltration (PI), MRI-defined diffuse infiltration (DI), and radiological infiltration [...] Read more.
Undifferentiated pleomorphic sarcoma (UPS) and myxofibrosarcoma (MFS) frequently exhibit infiltrative growth, but whether pathological and magnetic resonance imaging (MRI)-based findings represent the same tumor characteristics remain unclear. We examined the relationships among report-documented pathological infiltration (PI), MRI-defined diffuse infiltration (DI), and radiological infiltration (RI) based on the tail sign, and explored their associations with oncologic outcomes. This single-center retrospective cohort study included 68 treatment-naïve patients with primary UPS or MFS without distant or lymph-node metastasis at presentation who underwent curative-intent resection. The primary outcome was progression-free survival (PFS), with overall survival (OS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRFS) evaluated as secondary outcomes. Time-to-event associations were evaluated using Firth’s penalized Cox regression with parsimonious covariate adjustment and sensitivity analyses restricted to patients with R0 resection. DI, RI, and PI were observed in 75.0%, 76.5%, and 60.3% of patients, respectively. RI positivity was more frequent among patients with PI, whereas DI showed no clear relationship with PI or RI. In an exploratory multivariable model, DI (hazard ratio [HR], 3.30; 95% confidence interval [CI], 1.05–16.51; p = 0.040) and RI (HR, 4.26; 95% CI, 1.31–22.29; p = 0.013) were associated with worse PFS. Local recurrences occurred only in patients with PI, although adjusted estimates were imprecise. These findings suggest that pathological and MRI-based infiltrative markers may capture different and potentially complementary aspects of tumor behavior. External validation using standardized imaging and pathological review is required. Full article
(This article belongs to the Special Issue Advances in the Orthopaedic Oncology)
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13 pages, 1907 KB  
Article
Higher Negative Margin Rates with Intraoperative Ultrasound-Guided Excision for Myxofibrosarcoma: A Single-Center Cohort Study with External Comparisons
by Youngkeun Lee, Sujin Lee, Sang Ah Chi and Sung Wook Seo
Curr. Oncol. 2026, 33(9), 538; https://doi.org/10.3390/curroncol33090538 - 4 Sep 2026
Viewed by 202
Abstract
Background/Objectives: Myxofibrosarcoma (MFS) shows infiltrative fascial extensions that complicate margin achievement and drive local recurrence. We evaluated whether intraoperative ultrasound guidance improves negative margin achievement and oncological outcomes compared with conventional excision. Methods: In this retrospective cohort study at a single [...] Read more.
Background/Objectives: Myxofibrosarcoma (MFS) shows infiltrative fascial extensions that complicate margin achievement and drive local recurrence. We evaluated whether intraoperative ultrasound guidance improves negative margin achievement and oncological outcomes compared with conventional excision. Methods: In this retrospective cohort study at a single tertiary referral center, patients with MFS underwent conventional excision (2008–2013; n = 15) or ultrasound-guided excision (2014–2024; n = 50; primary comparative analysis n = 47 after excluding three patients). The primary outcome was negative margin achievement; secondary outcomes were overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS). Exploratory matching-adjusted indirect comparisons (MAICs) were performed against seven published international MFS cohorts. Results: Overall R0 (negative) margin rates did not differ between cohorts (97.9% vs. 93.3%; p = 0.428). Among R0 margins, however, a wide clearance (R0-wide, ≥1 mm) was more frequent in the US-guided cohort, whereas R0-close (<1 mm) margins predominated after conventional excision (R0-wide 83.0% vs. 46.7%; odds ratio 5.38, 95% CI 1.30–23.73; p = 0.014). Median follow-up was 49 months; five-year OS, LRFS, and DMFS were 97.5%, 94.3%, and 83.7%. In the internal historical comparison, LRFS was directionally higher with ultrasound guidance (94.3% vs. 68.2%; HR 0.26; p = 0.059). In MAICs, LRFS favored the US-guided cohort in all five comparisons and OS in two of four. Conclusions: Intraoperative ultrasound guidance was associated with a higher rate of wide (R0-wide, ≥1 mm) negative margins and favorable local disease control in MFS; whether wider microscopic clearance itself improves local control requires prospective multicenter evaluation. Full article
(This article belongs to the Special Issue Advances in the Orthopaedic Oncology)
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10 pages, 1377 KB  
Article
Transcriptomic Stratification Reveals an FRS2-Associated, Proliferation-Independent Phenotype in MDM2-High Sarcomas
by Takao Sakai, Hisaki Aiba, Makoto Yamaguchi, Koji Hagiwara, Hideki Murakami and Hiroaki Kimura
Curr. Oncol. 2026, 33(7), 438; https://doi.org/10.3390/curroncol33070438 - 22 Jul 2026
Viewed by 426
Abstract
Sarcomas with Murine Double Minute 2 (MDM2) amplification are considered potential candidates for MDM2-targeted therapy. However, the limited efficacy of MDM2 inhibitor monotherapy suggests that additional biological factors may influence tumor behavior and prognosis. This study investigated the relationship between MDM2 [...] Read more.
Sarcomas with Murine Double Minute 2 (MDM2) amplification are considered potential candidates for MDM2-targeted therapy. However, the limited efficacy of MDM2 inhibitor monotherapy suggests that additional biological factors may influence tumor behavior and prognosis. This study investigated the relationship between MDM2 expression and the Complexity Index in SARComas (CINSARC) transcriptomic signature, a gene expression signature that reflects cell division and chromosomal instability in soft tissue sarcomas. In the public GSE21050 dataset comprising 310 soft tissue sarcomas, the MDM2-low/CINSARC-low subgroup showed the most favorable metastasis-free survival, whereas the MDM2-high/CINSARC-low subgroup had an unfavorable metastasis-free survival comparable to that of the MDM2-high/CINSARC-high group. Among the representative genes in the 12q13-15 region, fibroblast growth factor receptor substrate 2 (FRS2) showed a strong positive correlation with MDM2 expression, but no significant correlation with CINSARC, suggesting an association independent of proliferative capacity. These findings suggest that proliferation-based risk assessment alone may underestimate the metastatic risk of a subset of MDM2-high sarcomas, and FRS2 may present a biologically relevant marker of aggressive behavior independent of tumor proliferation. Full article
(This article belongs to the Special Issue Advances in the Orthopaedic Oncology)
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Review

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26 pages, 4720 KB  
Review
Radiobiotherapy in Osteosarcoma: A State-Based Educational Framework for Strategy Selection and Trial Design
by Srinivasan Vijayakumar, Shirley Lewis, Marc Matrana, Robert J. Vasquez, Anshul Singh, Nicholas Duesbery, Anderson B. Collier, Zoe Larned, Jennifer Barr, Wayne R. Orr, Mary R. Nittala and Vani Vijayakumar
Curr. Oncol. 2026, 33(6), 342; https://doi.org/10.3390/curroncol33060342 - 8 Jun 2026
Viewed by 868
Abstract
Background: Osteosarcoma remains a biologically complex and clinically challenging malignancy, with survival gains plateauing despite decades of multimodal therapy incorporating surgery and cytotoxic chemotherapy. Unlike cancers in which mutation-centric precision oncology has yielded transformative advances, osteosarcoma is characterized by profound structural variation, [...] Read more.
Background: Osteosarcoma remains a biologically complex and clinically challenging malignancy, with survival gains plateauing despite decades of multimodal therapy incorporating surgery and cytotoxic chemotherapy. Unlike cancers in which mutation-centric precision oncology has yielded transformative advances, osteosarcoma is characterized by profound structural variation, copy number alteration dominance, and dynamic clonal evolution, limiting the effectiveness of single-target approaches. These realities motivate alternative strategy-level frameworks that better align treatment selection with evolving disease behavior. Methods: This narrative educational review synthesizes contemporary evidence from osteosarcoma biology, radiobiology, and translational oncology to propose a state-based framework for integrating radiotherapy—particularly stereotactic body radiotherapy (SBRT/SABR) and spatially fractionated radiotherapy (SFRT)—into osteosarcoma management and clinical trial design. Rather than relying solely on static anatomic stage, this framework emphasizes clinically actionable, time-varying state variables, including disease burden patterns (localized, oligometastatic, polymetastatic), tempo of progression, prior systemic response, and feasibility of complete local control. Results: Within this context, radiotherapy is presented not only as a local control modality but also as a hypothesis-generating biologic intervention, capable of perturbing tumor vasculature, inflammatory signaling, innate DNA-sensing pathways, and immune/myeloid programs in a dose-, fractionation-, and spatial-distribution-dependent manner. The review critically examines both the potential opportunities (e.g., local eradication, immune modulation) and limitations (e.g., rarity of abscopal responses, risk of unintended systemic signaling) of radiobiotherapy combinations, emphasizing the need for cautious interpretation and prospective validation. Conclusions: Finally, the article outlines practical implications for state-stratified, biomarker-embedded clinical trials, highlighting endpoints beyond conventional response criteria, including circulating tumor DNA dynamics, immune and myeloid signatures, and long-term patterns of disease progression. Overall, this review frames radiobiotherapy as an educational and investigational paradigm intended to support rational hypothesis generation, multidisciplinary decision-making, and learning-oriented trial designs in osteosarcoma, rather than as definitive clinical guidance. Full article
(This article belongs to the Special Issue Advances in the Orthopaedic Oncology)
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Graphical abstract

Other

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16 pages, 1347 KB  
Case Report
Pre-Spondylectomy Radiofrequency Ablation for Spinal Chordoma: An Illustrative Case and Systematic Review of Clinical Applications and Outcomes
by Holden Husbands, Drake Johnston, Matthan Tharakan, Ahmed Hussan, Kishore Balasubramanian, Patrick Bettiol, Benjamin Chou, Sanaa Hameed, Zachary A. Smith, M. Burhan Janjua, John F. Burke and Hakeem J. Shakir
Curr. Oncol. 2026, 33(9), 569; https://doi.org/10.3390/curroncol33090569 - 20 Sep 2026
Abstract
Chordomas are rare, locally aggressive spinal tumors. En bloc resection may improve local control but can cause substantial morbidity. Thermal ablation may provide a less invasive adjunct or alternative in selected cases. We systematically reviewed reports of radiofrequency ablation (RFA), cryoablation, laser interstitial [...] Read more.
Chordomas are rare, locally aggressive spinal tumors. En bloc resection may improve local control but can cause substantial morbidity. Thermal ablation may provide a less invasive adjunct or alternative in selected cases. We systematically reviewed reports of radiofrequency ablation (RFA), cryoablation, laser interstitial thermal therapy, high-intensity focused ultrasound, and similar thermal techniques for spinal or sacral chordoma to characterize their clinical applications and reported clinical and radiographic outcomes across pre-resection, primary non-operative, and palliative settings. Eligible studies reported at least one ablation-related clinical or radiographic outcome. Data were descriptively synthesized, and risk of bias was assessed using the Joanna Briggs Institute criteria. Thirteen studies including 33 patients and 34 ablated sites were identified. Cryoablation was used in 21 patients, RFA in 11 patients, and laser interstitial thermal therapy in one patient. Ablation was used as a pre-resection adjunct, primary treatment for unresectable disease, or palliation for recurrent or metastatic lesions. Most reports described pain improvement, short-term local stability, and few major complications. We also report an L4 chordoma treated with CT-guided RFA and vertebroplasty before staged en bloc spondylectomy, without a new neurologic deficit or local recurrence at 18 months. Thermal ablation may be a technically feasible adjunct, primary non-operative option, or palliative strategy for carefully selected spinal and sacral chordomas. In the presented mobile-spine case, planned pre-spondylectomy RFA was feasible before staged en bloc resection; however, limited follow-up and sparse heterogeneous literature preclude conclusions regarding long-term local control, recurrence reduction, survival, or routine use. Ablation should not replace oncologically appropriate en bloc resection when that procedure can be safely achieved and should be considered selectively within multidisciplinary chordoma care. Full article
(This article belongs to the Special Issue Advances in the Orthopaedic Oncology)
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