Journal of Bone Oncology最新文献

{"title":"Efferocytosis-associated transcriptomic patterns characterize prognosis and immune landscape in osteosarcoma","authors":"Xueliang Song ,&nbsp;Xiaofan Tou ,&nbsp;Li Li ,&nbsp;Fengxian Wang ,&nbsp;Chengqun Qian ,&nbsp;Ru Wang ,&nbsp;Jiahong Shen","doi":"10.1016/j.jbo.2026.100743","DOIUrl":"10.1016/j.jbo.2026.100743","url":null,"abstract":"<div><h3>Background</h3><div>Osteosarcoma (OS) is the most common primary malignant bone tumor in adolescents, characterized by high heterogeneity and poor prognosis. Efferocytosis, the clearance of apoptotic cells, has been implicated in tumor progression and immune evasion, but its role in OS remains unclear.</div></div><div><h3>Methods</h3><div>We integrated TARGET-OS as a training cohort with three GEO datasets for validation. Efferocytosis pathways were quantified by ssGSEA, and WGCNA was applied to identify associated gene modules. Candidate genes were screened using univariate Cox regression, and a prognostic signature was developed with machine learning models and validated across cohorts. Functional enrichment, immune infiltration, and immunotherapy prediction analyses were performed. scRNA-seq from six OS patients and spatial transcriptomic profiling were further used to characterize the cellular distribution and communication of efferocytosis-related genes. The functions of MAGEA11 in OS were explored both in vivo and in vitro.</div></div><div><h3>Results</h3><div>The Brown module showed the strongest association with efferocytosis pathways. The StepCox + Ridge model achieved robust prognostic performance and stratified patients into risk groups with significantly different survival. Enrichment analysis revealed upregulated genes related to endothelial and nitric oxide pathways, while downregulated genes were linked to immune signaling and extracellular matrix remodeling. High-risk patients exhibited elevated M2 macrophages, altered checkpoint expression, and greater predicted sensitivity to immunotherapy. At the single-cell level, efferocytosis activity was enriched in OS cells, with MAGEA11 showing the highest expression. High-risk tumors displayed stronger intercellular signaling, particularly from OS cells and CAFs to macrophages and endothelial cells. Spatial transcriptomics confirmed enrichment of efferocytosis at tumor and interface regions, correlating positively with stromal and myeloid cells and negatively with T cells. Mechanistically, MAGEA11 promoted OS tumor growth, and drove a pro-efferocytic microenvironment by enhancing Gas6 secretion, which polarized macrophages toward an M2 phenotype and upregulated their efferocytosis receptors (MERTK/AXL).</div></div><div><h3>Conclusions</h3><div>We established an efferocytosis-related prognostic signature and elucidated its underlying mechanism wherein MAGEA11 promoted immunosuppression via a Gas6-MERTK/AXL-dependent efferocytosis circuit. This integrated study positions efferocytosis as a key driver of the OS microenvironment and a promising target for clinical intervention.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"57 ","pages":"Article 100743"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questionable indication for postoperative radiotherapy after surgery for metastases of the major long bones: A single-centre cohort study of 552 fractures/526 patients","authors":"Jessica Ehne ,&nbsp;Adele Kastensson ,&nbsp;Rikard Wedin ,&nbsp;Panagiotis Tsagkozis","doi":"10.1016/j.jbo.2026.100746","DOIUrl":"10.1016/j.jbo.2026.100746","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of postoperative radiotherapy (PORT) as an adjunct to orthopaedic surgery of the long bones is widely recommended. Evidence of the benefits is however sparse. The primary research question of this study was whether PORT reduces the incidence of local failure after orthopaedic surgery for metastatic disease of the long bones.</div></div><div><h3>Method</h3><div>A prospectively collected database was retrospectively reviewed. A total of 552 fractures/526 patients were included. Primary endpoint was secondary surgery due to implant failure due to local tumour progression. The main analysis used a competing risk model with death as a competing event.</div></div><div><h3>Results</h3><div>PORT was administered in 197 cases, the median initiation time was 42 days and the most common schedule was 4 Gy × 5. 33 cases (6%) required revision attributed to tumour related implant failure. The cumulative incidence of failure was higher in the PORT group (p = 0.038). When dividing cases into subgroups depending on surgical method PORT had no effect in the osteosynthesis group and was significantly associated with a worse outcome in the prosthesis group. PORT dose and timing were not associated with failure rates.</div></div><div><h3>Conclusion</h3><div>In this cohort, PORT was associated with a significantly increased risk of tumour related failure in patients treated with a prosthesis. There was no significant effect in the osteosynthesis subgroup. Our results indicate that there is no clear evidence for the universal use of PORT.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"57 ","pages":"Article 100746"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective external validation of a three-predictor frailty model for 90-day survival and complications following spinal metastasis surgery","authors":"Pedro Reggiani Anzuategui ,&nbsp;Glauco José Pauka Mello ,&nbsp;Ana Valéria Brunetti Rigolino ,&nbsp;Lucas Emanuel Sauer Larocca ,&nbsp;Cássio Zini ,&nbsp;Carmen Australia Paredes Marcondes Ribas","doi":"10.1016/j.jbo.2026.100739","DOIUrl":"10.1016/j.jbo.2026.100739","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background context&lt;/h3&gt;&lt;div&gt;Surgical decision-making in patients with spinal metastases remains complex due to the need to balance potential surgical benefits with limited survival and common frailty. Predictive models can assist in this process, but their clinical utility is often limited by complexity and lack of validation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To externally validate a simple three-predictor frailty model for 90-day survival and complications, and to compare its performance with other commonly used tools.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study design/setting&lt;/h3&gt;&lt;div&gt;Prospective external validation study conducted at a single tertiary cancer center.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patient sample&lt;/h3&gt;&lt;div&gt;A consecutive cohort of 126 patients who underwent open posterior surgery with instrumentation for spinal metastases from solid tumors between 2018 and 2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcome measures&lt;/h3&gt;&lt;div&gt;Primary outcomes were 90-day survival and the occurrence of postoperative complications. Secondary outcomes included 30-day, 180-day and overall survival. Model performance was evaluated through discrimination (AUC), risk stratification, accuracy for surgical indication and calibration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The Anzuategui model (three predictors: tumor growth rate, comorbidities, and lymphocyte count) was applied preoperatively, along with four other three-predictor models (Tomita, Modified Bauer, Van der Linden, and Sioutos). Discrimination was assessed using ROC curves. Risk stratification was evaluated using predefined low-, moderate-, and high-risk categories, analyzed through Kaplan–Meier curves and complication rates. Model accuracy for surgical indication was calculated using a 90-day survival threshold as the reference. Calibration for both 90-day survival and postoperative complications was performed by comparing category-specific predicted probabilities derived from the development cohort with observed event rates in the validation cohort.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The Anzuategui model demonstrated predictive performance for the primary outcomes comparable to the other models under evaluation. It achieved an AUC of 0.78 (95% CI: 0.70–0.85) for 90-day survival and 0.68 (95% CI: 0.59–0.76) for postoperative complications. Risk stratification showed clear separation between survival curves across the three predefined categories. Accuracy for predicting appropriate surgical indication was 70% (95% CI: 61–78), with a sensitivity of 64% and specificity of 85%. Tomita and Modified Bauer models showed comparable accuracy (75% and 74%, respectively) but lower specificity. Calibration indicated overestimation of 90-day mortality (intercept –1.75; slope 2.05) and modest miscalibration for postoperative complications (intercept –0.40; slope 0.67).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The Anzuategui model demonstrated acceptable external performance, with greater validity for predicting 90-day survival than for post","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"57 ","pages":"Article 100739"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and oncologic outcome of en resection with intentional tumor transgression in primary spinal sarcoma: The Korean Society of Spinal Tumors multicenter study (KSST 2024–02)","authors":"Bong-Soon Chang ,&nbsp;Se-Jun Park ,&nbsp;Dong-Ho Kang ,&nbsp;Jae Hwan Cho ,&nbsp;Sehan Park ,&nbsp;Sang-Il Kim ,&nbsp;Young-Hoon Kim ,&nbsp;Sang-Min Park ,&nbsp;Sung-Kyu Kim ,&nbsp;Chang-Bae Kong ,&nbsp;Hyoungmin Kim ,&nbsp;Sam Yeol Chang","doi":"10.1016/j.jbo.2026.100747","DOIUrl":"10.1016/j.jbo.2026.100747","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary spinal sarcoma is rare and technically challenging, particularly when attempting en bloc resection with negative margins. Intentional tumor transgression may be used when Enneking-appropriate en bloc resection is not feasible, but its oncologic implications remain unclear. This study evaluated the feasibility and outcomes of en bloc resection with intentional tumor transgression compared with other resection strategies.</div></div><div><h3>Methods</h3><div>This multicenter retrospective study included patients who underwent surgery for primary spinal sarcoma across five tertiary hospitals from 2000 to 2022. Patients were grouped by resection method: (A) en bloc resection with negative margins, (B) en bloc resection with intentional tumor transgression, (C) piecemeal resection, and (D) subtotal resection. Tumor extent was assessed using a modified Weinstein-Boriani-Biagini classification. The primary outcome was overall survival; secondary outcomes included local recurrence, distant metastasis, and perioperative complications.</div></div><div><h3>Results</h3><div>The study included 119 patients (mean age 46.0 ± 19.8 years). Oncological outcomes (overall survival, local recurrence, and distant metastasis) demonstrated significant trends in survival analysis across groups A to D. Although Group B had more extensive disease (&gt;3 quadrants, canal encroachment, multi-level involvement), its overall survival, local recurrence, and distant metastasis did not differ significantly from Group A (hazard ratio [HR] 0.54, p = 0.467; HR 0.46, p = 0.307; HR 0.46, p = 0.237, respectively). Complication rates were comparable between groups A and B.</div></div><div><h3>Conclusion</h3><div>En bloc resection with intentional tumor transgression offers oncologic outcomes comparable to margin-negative en bloc resection in selected patients with more extensive tumors. This technique may be a viable alternative when Enneking-appropriate en bloc resection is not feasible.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"57 ","pages":"Article 100747"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential expression of CD74 and C1QB in jaw versus long bone osteosarcoma: Insights from animal models, public datasets and clinical cohorts","authors":"Lalan Zhang ,&nbsp;Jiaoyan Liu ,&nbsp;Shengjie Shao ,&nbsp;Xiang Liu ,&nbsp;Liqin Zhang ,&nbsp;Weihong Wang","doi":"10.1016/j.jbo.2026.100742","DOIUrl":"10.1016/j.jbo.2026.100742","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the differential expression of macrophage-related factors between jaw and long bone osteosarcoma, thereby providing potential candidates for future functional and mechanistic research.</div></div><div><h3>Methods</h3><div>Twenty-four Sprague-Dawley (SD) rats were randomly divided into control, jaw osteosarcoma, and long bone osteosarcoma groups. UMR106 cells were implanted subcutaneously in nude mice, then tumors were transplanted into rat jaw and tibial bone marrow to establish osteosarcoma models. Bone changes were observed using Micro-CT, while histological changes were examined with H&amp;E and Masson’s trichrome staining. Transcriptome sequencing identified differentially expressed genes (DEGs), with the top three genes selected using Cytohubba software. Survival analysis was performed using the GEPIA database. A retrospective analysis was conducted on jaw osteosarcoma patients and long bone osteosarcoma patients from November 2014 to June 2023. Finally, immunohistochemical staining validated the expression levels of relevant proteins in both animal and clinical tissue samples.</div></div><div><h3>Results</h3><div>Micro-CT revealed significant bone destruction in both osteosarcoma models. Histological analysis revealed high pleomorphism in osteosarcoma cells, predominantly spindle and polygonal shapes, with evident pathological mitosis. Transcriptome sequencing identified 414 DEGs, including the top three: <em>RT1-Da</em>, <em>CD74</em>, and <em>C1QB</em>. Survival analysis showed high expression of <em>CD74</em> and <em>C1QB</em> correlated positively with overall survival in patients with osteosarcoma. Immunohistochemistry demonstrated higher CD74 and C1QB expression in jaw osteosarcoma compared to long bone osteosarcoma in both rats and humans (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The expression levels of CD74 and C1QB were significantly higher in jaw osteosarcoma than in long bone osteosarcoma, suggesting that this differential expression may have clinical relevance for patient survival and warrants further investigation.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"57 ","pages":"Article 100742"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological features and survival disparities between axial and appendicular skeletal Angiosarcoma: A SEER-based analysis using competing risk models","authors":"Zhenliang Hao ,&nbsp;Xuewei Zhang ,&nbsp;Ning Yao ,&nbsp;Kai Li ,&nbsp;Luxin Lou ,&nbsp;Xuan Zheng ,&nbsp;Zhiming Guo ,&nbsp;Jiabin Chen ,&nbsp;Xuzhu Chen","doi":"10.1016/j.jbo.2026.100740","DOIUrl":"10.1016/j.jbo.2026.100740","url":null,"abstract":"<div><h3>Background</h3><div> <!-->Primary angiosarcoma of bone (ASB) is a rare and aggressive primary bone tumor. The prognostic significance of anatomical location (axial vs. appendicular skeleton) remains poorly defined. This study aimed to compare clinicopathological features and survival outcomes between these two groups.</div></div><div><h3>Methods</h3><div> <!-->Patients diagnosed with primary ASB (1975–2019) were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Tumors were categorized as axial (spine, pelvis, ribs, skull) or appendicular (extremities). Overall survival was analyzed using Kaplan-Meier and Cox models. Cancer-specific mortality (CSM) was evaluated with Fine-Gray competing risk regression to calculate subdistribution hazard ratios (SHR).</div></div><div><h3>Results</h3><div> <!-->Among 458 patients, 162 (35.4%) had axial and 296 (64.6%) had appendicular tumors. Axial patients were older (median 63 vs. 46 years, p &lt; 0.001), had higher distant metastasis at diagnosis (43.2% vs. 29.1%, p = 0.002), and underwent surgery less frequently (37.0% vs. 81.1%, p &lt; 0.001). The 5-year overall survival was significantly worse for axial tumors (16.8% vs. 38.2%, p &lt; 0.001). The 5-year cumulative incidence of CSM was 69.5% for axial versus 50.8% for appendicular tumors (p &lt; 0.001). Multivariate analysis confirmed axial location as an independent predictor of higher CSM (SHR 1.62, 95% CI: 1.25–2.10, p &lt; 0.001) ,<!--> <!-->independent of the year of diagnosis.</div></div><div><h3>Conclusions</h3><div>Axial tumors represent a distinct high-risk subgroup characterized by limited surgical resectability and inferior survival. Anatomical location should be considered a critical stratification factor in clinical management and future trials.</div><div>Abbreviations: <strong>ASB,</strong> Primary angiosarcoma of the bone; <strong>SEER,</strong> Surveillance, Epidemiology, and End Results; <strong>OS,</strong> Overall Survival; <strong>CSS,</strong> Cancer-Specific Survival; <strong>CSD,</strong> Cancer-Specific Death; <strong>CIF,</strong> Cumulative Incidence Function; <strong>SHR,</strong> Subdistribution Hazard Ratio; <strong>CI,</strong> Confidence Interval; <strong>HR,</strong> Hazard Ratio.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"57 ","pages":"Article 100740"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital spatial profiling of α-PD-1 treated breast cancer bone metastases reveals region-specific signaling and enrichment of immune-suppressive markers","authors":"Déja M. Grant ,&nbsp;Gwenyth J. Joseph ,&nbsp;Madeline Searcy ,&nbsp;Rachelle W. Johnson","doi":"10.1016/j.jbo.2026.100741","DOIUrl":"10.1016/j.jbo.2026.100741","url":null,"abstract":"<div><div>Bone is the most common and preferential site for breast cancer metastasis. Upon dissemination to the bone, breast cancer cells engraft into multiple niches, but it is unclear whether there are region-specific differences that may drive breast cancer progression in bone. We used a proteomic digital spatial profiling (DSP) approach to investigate which proliferation, cell death, and immune-related markers and pathways are enriched in immune and cancer cells residing 1) in the bone marrow or 2) along the endosteal surface, in an E0771, α-PD-1 treated pre-clinical model of breast cancer bone metastasis. We selected morphological markers to identify breast cancer cells and immune cells and applied a multiplexed set of probes targeting &gt;70 proteins to characterize breast cancer and immune cell signaling in the marrow and endosteal regions using a DSP platform. We found multiple immune suppressive markers were enriched in the endosteum, including Foxp3, CD163, CD27, Pd-1, and Pd-l1, while proliferation markers were enriched in tumor cells in the marrow, including p38 Mapk, pan-Ras, Mek1, and phospho-Erk1/2. These findings shed light on the niche-specific proteins and pathways that are activated in breast cancer bone metastases and establish a user-friendly highly multiplexed approach for spatial proteomics in pre-clinical models of bone metastasis.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"57 ","pages":"Article 100741"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial impact of COVID-19 pandemic on patients with solid malignancies and bone metastases (PsyCO-B): a multicentre prospective observational study","authors":"Paolo Taurisano ,&nbsp;Ester Cornacchia ,&nbsp;Maria Fara De Caro ,&nbsp;Vittorio Fusco ,&nbsp;Toni Ibrahim ,&nbsp;Anna Ragno ,&nbsp;Francesco Salonne ,&nbsp;Giulia Paparella ,&nbsp;Marta Betti ,&nbsp;Serena Penpa ,&nbsp;Maura Rossi ,&nbsp;Rossella Hakim ,&nbsp;Michela Pierini ,&nbsp;Camillo Porta ,&nbsp;Stella D’Oronzo","doi":"10.1016/j.jbo.2026.100744","DOIUrl":"10.1016/j.jbo.2026.100744","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19 pandemic dramatically changed our daily habits. Patients with cancer, particularly those with bone metastases (BM), were among the most concerned individuals, due to both their clinical condition and social distancing.</div></div><div><h3>Objectives</h3><div>This study aimed to explore psychosocial effects of the pandemic on patients with BM, investigating the role of clinical severity, psychological symptoms, coping strategies, and perceived traumatic impact.</div></div><div><h3>Methods</h3><div>Six questionnaires were administered to patients with BM from three Institutions: Hospital Anxiety-Depression Scale, WHO Quality of Life-BREF, Attitude Toward Seeking Professional Psychological Help, Brief Illness Perception Questionnaire, Brief COPE, and Impact Event Scale-Revised (IES-R). Clinical, pathological, and socio-demographic data were collected and analyzed using descriptive statistics. Clinical severity was estimated by applying a specific prognostic model. Statistical analyses included correlations, linear regressions and mediation analyses.</div></div><div><h3>Results</h3><div>Clinical severity was significantly associated with depressive symptoms whereas the perceived traumatic impact of the COVID-19 pandemic was strongly associated with anxiety, the use of specific coping strategies (social support, avoidance and religiosity) and greater openness to psychological support. Mediation analysis showed that the IES-R mediates the relationship between subjective perception of illness and anxiety.</div></div><div><h3>Conclusions</h3><div>During the pandemic, depressive symptoms in patients with BM were mainly related to their specific clinical condition, whereas those associated with anxiety were mostly due to the experience of pandemic-associated trauma. The psychological impact of the pandemic influenced coping strategies and the request for support, regardless of the disease severity. These findings highlight the importance of psycho-oncological support focused on the patient’s experience and clinical condition.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"57 ","pages":"Article 100744"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically aligned whole-body MRI segmentation of skeletal metastases via Supervised Anatomical Pretraining","authors":"Joris Wuts ,&nbsp;Jakub Ceranka ,&nbsp;Nicolas Michoux ,&nbsp;Frédéric Lecouvet ,&nbsp;Jef Vandemeulebroucke","doi":"10.1016/j.jbo.2026.100745","DOIUrl":"10.1016/j.jbo.2026.100745","url":null,"abstract":"<div><div>In oncology practice, response assessment of metastatic disease requires reliable and reproducible quantification of measurable metastatic burden. Manual identification, segmentation, and volumetry of all lesions is labor-intensive and variable, limiting routine clinical adoption. An automated approach is therefore needed. Segmenting metastatic bone disease (MBD) on whole-body MRI (WB-MRI) is challenging because of the heterogeneous appearance and anatomical distribution of lesions, ambiguous boundaries, and the low volumetric prevalence of metastatic deposits within the body. Training robust machine learning models for this task requires large, well-annotated datasets that capture lesion variability. However, assembling such datasets demands substantial expert time and is prone to annotation error. Although self-supervised learning (SSL) can take advantage of large unlabeled datasets, the learned representations tend to remain generic and may miss the subtle anatomical and pathological features essential for accurate lesion detection.</div><div>In this work, we propose a Supervised Anatomical Pretraining (SAP) method that learns from a limited dataset of anatomical labels. First, an MRI-based skeletal segmentation model is developed and trained on WB-MRI scans from healthy individuals for high-quality skeletal delineation. Then, we compare its downstream efficacy in segmenting MBD on a cohort of 40 patients with metastatic prostate cancer, against a randomly initialized baseline and a state-of-the-art self-supervised method.</div><div>SAP significantly outperforms both the Baseline and SSL-pretrained models achieving a normalized surface Dice of 0.78 and a Dice coefficient of 0.66. The method achieved a lesion detection <span><math><msub><mrow><mi>F</mi></mrow><mrow><mn>2</mn></mrow></msub></math></span> score of 0.45, improving on 0.26 (Baseline) and 0.31 (SSL). When considering only clinically relevant lesions larger than 1 mL, SAP achieves a mean lesion level sensitivity of 0.89 at 0.46 false positives per exam, supporting reliable follow-up and treatment-response assessment.</div><div>Learning bone morphology from anatomy yields an effective and domain-relevant inductive bias that can be leveraged for the downstream segmentation task of bone lesions. These results highlight SAP’s clinical utility for standardized, high-sensitivity WB-MRI monitoring of skeletal metastases in routine bone oncology practice. All code and models are made publicly available.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"57 ","pages":"Article 100745"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathological fractures as an adverse prognostic factor in chondrosarcoma: Results of a systematic review, meta-analysis and institutional case series","authors":"Julian P. Maier ,&nbsp;Ida Peiss ,&nbsp;Felix Klingler ,&nbsp;Nikos Karvouniaris ,&nbsp;Kilian Reising ,&nbsp;Hagen Schmal ,&nbsp;Georg W. Herget","doi":"10.1016/j.jbo.2025.100735","DOIUrl":"10.1016/j.jbo.2025.100735","url":null,"abstract":"<div><h3>Background</h3><div>Pathological fractures are recognized as a potential, adverse prognostic factor in primary bone sarcomas. While some studies suggest higher recurrence rates and reduced survival, robust data specific to chondrosarcoma (CS) remain limited. This study evaluates the prognostic relevance of pathological fractures (PF) in CS patients.</div></div><div><h3>Methods</h3><div>A systematic review and <em>meta</em>-analysis were conducted according to PRISMA guidelines. Eligible studies included patients with CS of the bone, with comparative groups based on fracture status and oncological outcomes. Study design, quality, and endpoints were assessed, and pooled <em>meta</em>-analysis was conducted. Additionally, clinical data from an institutional cohort was analyzed retrospectively.</div></div><div><h3>Results</h3><div>Nine studies, with a total of 1,185 patients and 245 PF cases, met the inclusion criteria. Meta-analysis revealed that PF status was significantly associated with inferior survival at 1–5 years (pooled OR 0.40; 95 % CI 0.26–0.62; p &lt; 0.0001). The increased risk of death was particularly evident in dedifferentiated CS (pooled HR 1.96; 95 % CI 1.46–2.63; p &lt; 0.00001). Institutional data supported these findings, that PF was associated with worse overall survival (HR 3.90; 95 % CI 0.69–21.98; p = 0.12) and progression-free survival (HR 3.17; 95 % CI 0.58–17.36; p = 0.18), although significance was limited by sample size.</div></div><div><h3>Conclusions</h3><div>Pathological fractures entail a significantly adverse prognosis in chondrosarcoma, particularly in high-grade and dedifferentiated subtypes and within the first 5 years of follow-up. Our institutional data corroborates <em>meta</em>-analysis findings. These results underscore the importance of personalized surgical management and intensive outcome monitoring for CS patients presenting with PF.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"56 ","pages":"Article 100735"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}