Standardization of rehabilitation after limb salvage surgery for sarcomas improves patients' outcome

The purpose of this study is to establish a standardized postoperative rehabilitation protocol following limb salvage surgery [LSS] in patients with primary bone sarcoma in five major anatomical locations: distal femur, proximal tibia, proximal and total femur, humerus and shoulder girdle and pelvic resections. Retrospective study. All LSSs were performed by an orthopedic oncology surgeon, and rehabilitation of all patients was based on a devised standardized rehabilitation protocol. Patient outcomes were measured using the modified Musculoskeletal Tumor Society-International Symposium on the Limb Salvage [MSTS-ISOLS] scoring system. A total of 59 patients received LSS in the above mentioned locations; endoprostheses were used in 49, bone allograft in five, while no replacements were made in five patients. At a mean follow-up of 24 months, the mean modified MSTS-ISOLS score for all patients was 87% [95% CI; 0.85-0.89]. The highest scores were encountered for patients with distal femur replacement: 93% [95% CI; 0.91-0.95]. Seven patients had interruption of more than six weeks in their rehabilitation and had a mean score of 71% [95% CI; 0.64-0.82]. The proposed rehabilitation protocol is a comprehensive, organized and applicable guideline to be used after performing LSS at the above mentioned anatomical locations. The use of standardized rehabilitation protocol resulted in improved patient functional outcome

Retinoblastoma in Jordan: an epidemiological study [2006-2010]

The epidemiological characteristics of retinoblastoma have been extensively studied in developed countries, however epidemiological data is scarce in the Middle East. We present a detailed epidemiological analysis of retinoblastoma in Jordan in an attempt to aid national and regional strategies for improved cancer surveillance and control. Retrospective review of retinoblastoma cases presenting to the sole and exclusive ocular oncology referral center in Jordan. Forty children [59 eyes] presenting with clinically and/or histologically confirmed retinoblastomas were treated at King Hussein Cancer Center [Amman, Jordan] between January 2006 and December 2010. This case series included 28 boys and 12 girls. Data relating to age at diagnosis, laterality, gender, treatment modality and survival were recorded. The mean age-adjusted incidence of retinoblastoma in Jordan was 9.32 cases per million children per year for children aged 0-5 years. The male: female ratio was 2.3:1. Bilateral cases were encountered in 19 patients [47.5%] while 21 patients [52.5%] harbored unilateral retinoblastoma. At the time of follow-up, 38 patients [95%] were alive. Overall, 40 eyes [67.8%] were successfully preserved without the need for enucleation. The national epidemiological data gathered in this study indicates that the incidence of retinoblastoma in Jordan is similar to that reported in various countries of the world. Jordanian boys, however, are at significantly higher risk for developing retinoblastoma than age-matched girls. Furthermore, Jordanian patients are more likely to harbor bilateral retinoblastoma