Onco Wiki / Bandeira vermelha

Recidiva local no leito cirúrgico, novas metástases pulmonares na TC de vigilância, ma...

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Origem da bandeira vermelha

Lógica de Desencadeamento

{
  "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"
}

Notas

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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