Results of Limb Salvage for Malignant Bone Tumors.

概要

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Nineteen patients with malignant bone tumors treated by limbsalvage procedures were evaluated. Histological diagnoses were chondrosarcoma (6), osteosarcoma (6), malignant fibrous histiocytoma (2), Ewing's sarcoma (2) and giant cell tumor (3). The surgical stages were: Stage I B (6), Stage II A (2), Stage II B (9) and Stage III (2). Fourteen patients were treated by preoperative and/or postoperative intra-arterial chemotherapy. The operative procedures were tumor resection alone (5) and reconstruction with bone graft (3), bone cement (2), prosthetic Numeral head (1), total shoulder arthroplasty (2) and total knee arthroplasty (5). One patient required no surgery, following complete response with intra-arterial high-dose adriamycin.The most common complication of patients with marginal (5) or intra-lesional surgical margin (2) was local recurrence (36%).Functional evaluations were excellent (7), good (10), fair (2) and poor (3). Metastasis was 47%, death 42% and disease free survival 58% with a mean follow-up of 55 months. Careful preoperative selection and attention to limb salvage procedures are important for a successful outcome.
西日本整形・災害外科学会の論文