CCBD: Comprehensive Orthopedic Oncology

The Comprehensive Orthopedic Oncology Clinic (COONC), established in 1989, continues to see patients with complex musculoskeletal tumors in a multidisciplinary clinic. Attended by members of the oncology team, social work, child life, psychology, prosthetics, physiotherapy and musculoskeletal surgical oncology, a comprehensive visit allows the opportunity for patients to be seen at one time but also allows the interdisciplinary team to make patient care decisions during the pre-clinic conference aimed at careful review of all patient clinical details. Opportunities for education for trainees in all subspecialty services participant in the clinic are available and Pediatric Hematology/Oncology fellows are expected to attend the clinic when their primary patients are seen to facilitate discussion and decision making.

Program Highlights

• Active enrollment of all newly diagnosed patients into national and institutional research protocols.
• Members of the clinic are actively involved in clinical research protocols – Dr. Patrick Leavey is chair of the Children’s Oncology Group study for patients with recurrent Ewing sarcoma while Drs. Gary Maale and Jorge Casas present reviews of some of the largest series of patients following complex reconstruction surgeries.

Research

• Institutionally plans are underway to open a study exploring the prevalence of depression and anxiety in patients with newly diagnosed malignancies –patients seen at the COONC will be active participants in this clinical trail and, given their need for multiple surgeries and intensive chemotherapy, are potentially a subset of patients requiring specific investment of resources.
• Recent publications from groups members include:

Leavey PJ,  Mascarenhas L, Marina N, Chen Z, Krailo M, Miser J, Brown K, Tarbell N, Bernstein ML, Granowetter L, Gebhardt M and Grier HE. Prognostic Factors for Patients withEwingsarcoma (EWS) at First Recurrence Following Multi-modality Therapy – A report from the Children’s Oncology Group. Pediatr Blood Cancer. 2008 Sep;51(3):334-8.

Granowetter L, Womer R, Devidas M, Krailo M, Wang C, Bernstein M, Neyssa M, Leavey P, Gebhardt M, Healey J, Shamberger RC, Goorin A,  Miser J, Meyer J, Arndt C, Sailer S, Marcus KJ, Perlman E, Dickman PS and Grier H. Comparison of dose intensified versus standard chemotherapy for non-metastatic Ewing Sarcoma Family of Tumors (ESFT): A Children’s Oncology Group Study Report. Journal of Clinical Oncology (in press 2008).