Techniques of reconstructive surgery. Experience in reconstructing postoperative defects in children with forearm bone sarcomas. Case series
Bibliographic record
Abstract
Introduction. Osteosarcoma is an extremely malignant mesenchymal, highly differentiated tumor from bone tissue, proceeding aggressively, characterized by the rapid development of distant metastases. Ewing's sarcoma is not less complex disease, which can be explained by its biological characteristics, including aggressive course, a tendency to develop early hematogenous metastases and frequent relapses.The aim of the study – checking the possibility of complications, the level of restoration of functions according to the Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (МSTS) scales after endoprosthesis, and the installation of a spacer.Materials and methods. We analyzed clinical cases of 7 children aged 8 to 15 years, who received treatment at the N.N. Blokhin National Medical Research Center of Oncology, оf the Ministry of Health of Russia in the period 2013–2019. Osteosarcoma was diagnosed in 4 patients, and Ewing’s sarcoma in 3 patients. They underwent organ-preserving surgical treatment of the upper limb in one of three ways – endoprosthesis, placement of a spacer, and replacement with autologous bone on microvascular anastomoses. In the course of the study, a method was used to assess limb function according to the TESS and МSTS scales.Results. It was found that in the postoperative period in all patients, regardless of the applied method of organ-preserving surgery, the results varied within 1,4–1,5 on the TESS scale, and 91–95 % on the MSTS scale. Postoperative complications in the form of post-traumatic neuropathy and dislocation were identified in 4 patients. 1 patient had local recurrence, 1 patient was diagnosed for metastatic leisure of lung tissue. It should be noted that the condition of all patients is currently satisfactory, no lethal cases have been identified.Conclusion. We believe that the results of this study are promising. However, it is necessary to conduct a longer period of observation of patients and evaluate their 5-year survival.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".