Tumor

The local Department of Orthopaedics and Orthopaedic Surgery is an internationally renowned specialized Center for Tumor- and sarcoma surgery. Embedded into the CCC (Comprehensive Cancer Center Vienna) the department combines competent, interdisciplinary medical care for sarcoma patients with scientific research and teaching at the highest academic level.

The Tumor Cluster main activities encompass everything between prediction of survival outcomes, precision technology from diagnosis (Ultrasound guided- needle biopsy), and CT-guided and navigated or fluorescence -guided surgical treatment until patient-reported outcomes measurement including Quality of life and Sporting Activities after sarcoma treatment.  

Our scientific work in the last decade and ongoing work:

• Evaluation of (novel) prognostic markers:
  Certain blood serum parameters, specifically, elevated preoperative CRP and neutrophil/lymphocyte (N/L) ratio as markers of systemic inflammatory response have been found to be associated with decreased overall survival in Soft tissue sarcoma (STS). Our studies provided evidence Low albumin and a high albumin-creatinine-ratio independently predict poor overall survival in this patient cohorts. 
• Evaluation of the diagnostic and surgical questions:
  • Sarcoma resected without clear margins require re-resection. In our findings we could demontrate that inadequate excision of a STS does not cogently mean deterioration of overall survival but necessitates an ample and quick re-resection within 12 weeks.
  • US guided biopsy performed in an outpatient setting by the orthopaedic surgeon himself: In our study malignancy was correctly diagnosed in 87%.
  • Evaluation of CT guided bone sarcoma resection and CT-guided navigation assisted surgery of benign tumors (e.g. osteoidosteoma)
  • Evaluation of intraoperative near-infrared Fluorescence Imaging Guidance for oncological resection of bone and soft tissue sarcoma by Indocyanine Green (ICG) 
• Evaluation of sports activity and life quality after tumour resection:
  • There is a desire to participate in sports in young as reflected in high numbers of patients participating in sports at 5-year followup, and data can show that patients after tumor megaprostheses of the proximal femur or knee can regularly play moderate sports and may be able to reach comparable levels to patients after elective hip surgery after 5 years.
  • (see also PROMS/RDA Cluster Report-link)

Principal investigators

• Assoc.Prof. Priv.-Doz. Dr. Joannis Panotopoulos
• Assoc.Prof.Priv.-Doz Dr. Philipp Funovics

Important publications

• Chondrosarcoma of the Pelvis, Gerhard M. Hobusch, Reinhard Windhager. Book chapter in Surgery of Pelvis Bone Tumors, Springer ISBN: 978-3-030-77007-5, Book chapter, Pages 55-62.
• Diagnostic accuracy of ultrasound-guided core needle biopsy versus incisional biopsy in soft tissue sarcoma: an institutional experience. Cernakova M, Hobusch GM, Amann G, Funovics PT, Windhager R, Panotopoulos J. Sci Rep. 2021 Sep 8;11(1):17832. doi: 10.1038/s41598-021-96953-w. PMID: 34497298.
• Complications, mobility, and quality of life in ankle sarcoma patients. Smolle MA, Leithner A, Kapper M, Demmer G, Trost C, Bergovec M, Windhager R, Hobusch GM. Bone Joint J. 2021 Mar;103-B(3):553-561. doi: 10.1302/0301-620X.103B3.BJJ-2020-1308.R1. PMID: 33641415.
• What Opinions Do Tumor Reconstructive Surgeons Have about Sports Activity after Megaprosthetic Replacement in Hip and Knee? Results of the MoReSports Expert Opinion Online Survey. Hobusch GM, Keusch F, Tsuchiya H, Joyce M, Windhager R. J Clin Med. 2020 Nov 12;9(11):E3638. doi: 10.3390/jcm9113638. PMID: 33198264.
• What Sport Activity Levels Are Achieved in Patients After Resection and Endoprosthetic Reconstruction for a Proximal Femur Bone Sarcoma? Hobusch GM, Bollmann J, Puchner SE, Lang NW, Hofstaetter JG, Funovics PT, Windhager R. Clin Orthop Relat Res. 2017 Mar;475(3):817-826. doi: 10.1007/s11999-016-4790-7. PMID: 27020426. 
• C-reactive protein: An independent predictor for dedifferentiated chondrosarcoma. Nemecek E, Funovics PT, Hobusch GM, Lang S, Willegger M, Sevelda F, Brodowicz T, Stihsen C, Windhager R, Panotopoulos J. J Orthop Res. 2018 Oct;36(10):2797-2801. doi: 10.1002/jor.24030. PMID: 29701260; PMCID: PMC6220779.
• Hemoglobin, alkalic phosphatase, and C-reactive protein predict the outcome in patients with liposarcoma. Panotopoulos J, Posch F, Alici B, Funovics P, Stihsen C, Amann G, Brodowicz T, Windhager R, Ay C.  J Orthop Res. 2015 May;33(5):765-70. doi: 10.1002/jor.22827. PMID: 25641201.
• Serum creatinine and albumin predict sarcoma-specific survival in patients with myofibroblastic and fibroblastic sarcomas. Willegger M, Posch F, Schieder S, Funovics PT, Scharrer A, Brodowicz T, Ay C, Windhager R, Panotopoulos J. J Orthop Res. 2017 Dec;35(12):2815-2824. doi: 10.1002/jor.23598. PMID: 28485477.
• Elevated serum creatinine and low albumin are associated with poor outcomes in patients with liposarcoma. Panotopoulos J, Posch F, Funovics PT, Willegger M, Scharrer A, Lamm W, Brodowicz T, Windhager R, Ay C.  J Orthop Res. 2016 Mar;34(3):533-8. doi: 10.1002/jor.23002. PMID: 26222652.