Musculoskeletal Tumours area
The Clínica Universidad de Navarra was one of the first centres in the world to introduce limb conservative surgical procedures, as well as opportune adjuvant treatments.
Therefore we are currently one of the most prestigious centres in the world in this field and our team of professionals is internationally recognised for their work.
Since the 1980s, more than 1,500 patients with sarcomas have been treated in our centre. Given that this is a rare disease, there are very few hospitals with the necessary experience. The Clínica has welcomed patients from many countries around the world.
The Clínica has some of the most modern and sophisticated equipment for diagnosis and treatment of this disease. Similarly to other cancers, early diagnosis and treatment are essential in order to achieve the best results.
In our centre, all our diagnostic testing (including biopsies) can usually be carried out in less than 24 hours. Furthermore, we have very well trained teams of professionals in intra-arterial chemotherapy, brachytherapy, isolated limb perfusion, etc.
In experienced centres, the possibility of conserving the affected limb is much higher, without affecting the patient´s chance of survival. 25 years ago limbs were always amputated and in nearly all cases, the patients died. Today, the statistics have reversed: nearly all limbs are conserved and the rate of survival is very high.
In the majority of prestigious hospitals for this disease worldwide, the move from limb amputation to conservation has been introduced gradually over the last few decades. At first, it was only possible to conserve the limb in very specific cases. But, little by little the number of conserved limbs has increased.
At the Clínica Universidad de Navarra, this step was dramatically made at the end of the 1970s when specialists only knew about the extraordinary efficiency of chemotherapy. Surgeon, Dr. Cañadell´s efforts, helped by a team of other professionals, meant that we now try to conserve the limbs of almost all our patients.
To cure malignant bone tumours, it´s essential to completely remove the lesion, including the area of the initial biopsy. This is why it is important that the same surgeon, who will carry out the definitive operation, does the biopsy as well. For limb reconstruction, there are many options for treatment, depending on the patient´s age, preference and the surgeon´s experience, etc. All surgical options have their advantages and their possible complications, worsened by the fact that the patient could be receiving treatment to reduce their immune system (which therefore increases their risk of contracting surgical infections), or limit the healing ability of their tissues (like radiotherapy). Normally, these difficulties can be resolved.
Another possible adversity is the discrepancies in the length children´s limbs when affected by these lesions. There are also solutions for this eventuality. We must remember that the main objective is to cure the disease, whilst still causing the minimal amount of negative consequences for the patient, which presents a challenge.
At the Clínica Universidad de Navarra, in the last 20 years we have treated more than 1000 primary malignant bone tumours. For osteosarcoma, the survival rate is currently around 74% after 10 years; with a rate of preservation of limbs is greater than 90%.
25 years ago, the worry was whether the patient would survive or not. Then, doctors began to conserve the patients´ limbs, although they were not fully functional. Next, they increased the limb´s functionality as much as possible. And, although it seems a little peculiar, considering the circumstances, having contracted cancer, for some patients having a scar after treatment is a big concern.
It is not possible for just one doctor to cure this disease, even if they are a specialist in the field.
It is essential to combine the work of specialists in all relevant areas (oncologists, radiologists, paediatricians, radiotherapeutic oncologists, pathologists, surgeons, physical therapists, nurses, psychologists, etc.)
At the Clínica Universidad de Navarra each patient is attended by a team following the case, resulting in fewer delays which could negatively affect the efficiency of the treatment.
We continue to research every day to discover why a small percentage of patients do not obtain the expected results from their treatment and to improve patient care at the Clínica.
The Clínica, in collaboration with the Centre of Applied Medical Investigation (CIMA), looks for innovative, new treatments, which will allow us to increase the current rate of patients cured.
As a result, we have published numerous publications, many of which are in collaboration with the most prestigious investigators in the world for this field.
For some sarcomas, the genetic mechanism responsible for the growth of these malignant cells is already known and we are therefore looking for ways in which to counteract this change.
For other more complex cases, we are looking for ways to add new therapies to the conventional cytostatic ones or study the resistance of some tumours to standard treatments.
We are also researching carcinogenic cells mechanisms in the bone which specifically target (or have a certain ´attraction´ for) the lungs when giving metastasis.
Revista Española de Cirugía Ortopédica y Traumatología Jul 7, 2018
In other centres, they told me that the only solution was to amputate my leg. At the Clínica, they never once told me that I was going to lose my leg”.
Patient operated on for osteosarcoma