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Department of Musculoskeletal Oncology and Rehabilitation

Fumihiko Nakatani

Introduction

The Department of Musculoskeletal Oncology and Rehabilitation of the National Cancer Center Hospital East (NCCHE) is a team consisting of a panel of orthopedic surgeons and rehabilitation professionals that started from 2012. We strive to provide expert interdisciplinary care for a variety of benign and malignant bone and soft tissue tumors and tumor-like conditions, and we also provide comprehensive rehabilitation services. Currently, we have a chief orthopedic surgeon and three rehabilitation staff engaging in the treatment of a variety of patients with the aid of other orthopedic staff from the NCCH.

Routine activities

Our outpatient service is open three days a week (Mondays, Wednesdays and Fridays) for patients with a variety of musculoskeletal tumors or cancer patients who need rehabilitation care. We also manage the patients with bone metastases or other orthopedic diseases as a result of consultation from other cancer specialists on a daily basis. To provide the prosthetic and orthotic care for our patients a special outpatient service is open every Friday. In cases of patients who need multidisciplinary approaches to their treatment, we offer appropriate referral to the NCCH for further treatment.

In 2015, we conducted 37 operations in total, consisting of 17 resections of soft tissue tumors, four osteosyntheses of pathological fractures from bone metastases, 13 operations for bone tumors and three operations for other tumors/reasons.

In September 2014, we opened a spacious rehabilitation unit with start-of-the-art equipment with the aim to reduce the common side effects of cancer treatment, including fatigue, weakness, poor endurance, pain, nausea, anxiety, depression and loss of confidence. As a result, we conducted rehabilitation for 1,127 patients in 2015 (Table 1).


Table 1. Characteristics and number of patients enrolled for rehabilitation.

Research activities

We have been focusing on regional cooperation with the local physiotherapists of Kashiwa City with the aim to provide cancer patients of the community with seamless rehabilitation care after invasive cancer operations. Until now, we have established the standard methods of physiotherapy and functional evaluations in common.

Clinical trials

We have been focusing on the standardization of multidisciplinary treatment for bone and soft tissue sarcomas through cooperation with the musculoskeletal oncology department of the NCCH. Two multi-institutional clinical trials are active as follows:

  1. A multi-institutional phase III clinical trial of multidrug adjuvant chemotherapy for osteosarcoma (JCOG 0905) has been ongoing since 2010.
  2. A multi-institutional phase III clinical trial of adjuvant chemotherapy for high-grade soft part sarcoma (JCOG 1306) started in February 2014.

Education

We have undertaken several educational lectures for the medical staff to highlight the importance of rehabilitation for cancer treatment. We also provide some instructive lectures for the medical staff of the community.

Future prospects

Recent evolution of cancer treatment increases the demand for the orthopedic care and rehabilitation of cancer survivors. We must consistently focus on standardization for the methodology of rehabilitation for all cancer patients, which will be beneficial for the augmentation of quality of life for these patients.

List of papers published in 2015

Journal

  1. Yamaga K, Kobayashi E, Kubota D, Setsu N, Tanaka Y, Minami Y, Tanzawa Y, Nakatani F, Kawai A, Chuman H. Pediatric myositis ossificans mimicking osteosarcoma. Pediatr Int, 57:996-999, 2015
  2. Fujiwara T, Ogura K, Kobayashi E, Tanzawa Y, Nakatani F, Chuman H, Kawai A. Clinical Outcomes of Surgical Treatments for Primary Malignant Bone Tumors Arising in the Acetabulum. Sarcoma, 2015:430576, 2015
  3. Fujiki M, Miyamoto S, Nakatani F, Kawai A, Sakuraba M. Rotationplasty with vascular reconstruction for prosthetic knee joint infection. Case Rep Orthop, 2015:241405, 2015
  4. Miyamoto S, Fujiki M, Nakatani F, Sakisaka M, Sakuraba M. Free flow-through anterolateral thigh flap for complex knee defect including the popliteal artery. Microsurgery, 35:485-488, 2015