Onco Wiki / drapeau rouge

Récurrence locale dans le lit chirurgical, nouvelles métastases pulmonaires sur la surveillance CT, ma...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

Origine du drapeau rouge

Logique de déclenchement

{
  "any_of": [
    {
      "finding": "local_recurrence_surgical_bed",
      "value": true
    },
    {
      "finding": "new_pulmonary_metastasis",
      "value": true
    },
    {
      "finding": "enchondroma_malignant_transformation",
      "value": true
    },
    {
      "finding": "pathologic_fracture_through_tumor",
      "value": true
    }
  ],
  "type": "composite_clinical"
}

Notes

Chondrosarcoma metastasizes preferentially to lung — surveillance chest CT every 6–12 mo for ≥10 years standard. Pulmonary metastasectomy for oligometastatic disease yields long-term survival in ~30% of resected patients (extrapolated from sarcoma literature). Local recurrence post-resection rate is grade-dependent (10% grade I, 50% grade III) — re-biopsy mandatory because grade upgrade and dedifferentiation can change adjuvant strategy. Pathologic fracture requires en-bloc resection (pre-fracture curettage no longer adequate — tumor seeding through fracture hematoma). Ollier / Maffucci patients require lifetime imaging surveillance — ~25% lifetime malignant transformation risk.

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