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CTOS: A Herman Suit Legacy

CTOS: A Herman Suit Legacy. Michael A. Simon, MD The University of Chicago. Herman Suit MD MSc. PhD Andres Soriano Professor Department of Radiation Oncology Harvard Medical School Chief, Department of Radiation Oncology, Massachusetts General Hospital.

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CTOS: A Herman Suit Legacy

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  1. CTOS: A Herman Suit Legacy Michael A. Simon, MD The University of Chicago

  2. Herman Suit MD MSc. PhD Andres Soriano Professor Department of Radiation Oncology Harvard Medical School Chief, Department of Radiation Oncology, Massachusetts General Hospital

  3. Journal of Bone and Joint Surgery April 1976

  4. Cancer May 1973

  5. Cancer October 1977

  6. Cancer October 1981

  7. 1975 -1985 Advances Surgery and Radiation Therapy for Soft Tissue Sarcoma became standard • Limb salvage rate increased from 50% 90-95% • No compromise in survival

  8. 1993 – 1994 Suit Founded Connective Tissue Oncology Society (CTOS) • 1993 - 1994 Planning Meetings • 1995 - CTOS Founded • 1997 - CTOS Incorporated

  9. Journal of Bone and Joint Surgery April 1970

  10. New England Journal of Medicine November 1974 The New England Journal Of Medicine Amputation and Adriamycin in Primary Osteosarcoma E. P. Cortes, J.F. Holland, J. J. Wang, L. F. Sinks, J. Blom, H. Senn, A. Bank, O. Glidewell New England Journal of Medicine December 1974

  11. Cancer January 1976

  12. Journal Bone and Joint Surgery 1986

  13. 1975 -1985 Advances Musculoskeletal Tumor Society (MSTS) performed multi-institutional studies on: • Biopsy - Mankin • Staging - Enneking • Limb salvage - Simon

  14. 1975 -1985 Advances Limb salvage & Neoadjuvant chemotherapy established for Osteosarcoma and Ewings • Limb salvage rate increased from α5 -10% α90-95% • Osteosarcoma survival rate increased from α20%  α65% • Ewings Sarcoma survival rate increased from α5 -10%  α65%

  15. Thoracotomy cures overall about 10% of Osteosarcoma patients 1975 -1990 Advances

  16. 1980 -1990 Huge Imaging Advances • CT Lungs • Staging • Thoracotomy decisions/planning • MRI of Limbs • Limb salvage predictable and safe

  17. 1975 -1990 Surgical Advances in Skeletal Reconstruction • Allograft and/or Prosthetic • reconstruction for skeletal defects in • bone sarcomas

  18. 1990 – Present What progress has been made in the last 15 years when compared to 1975-1990?

  19. 1990 – Present: Perfecting Current Techniques • Surgery • skeletal reconstruction on allograft vs. prosthetic replacement for bone sarcomas • Radiation Therapy for Soft Tissue Sarcomas • pre-op vs. post operative RT • Medical Oncology for Bone Sarcomas • dose intensity • combination changes

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