Limb salvage surgery for primary bone tumors: retrospective study in a tertiary care centre
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20240419Keywords:
Primary bone tumors, Limb salvage surgery, Custom mega prosthesisAbstract
Background: Limb salvage surgery is the standard of care for patients with primary bone tumors. The study retrospectively analyses a single center experience of use of endo-prosthesis for limb conservation in cases of primary bone tumors over a five-year period (2015-2020).
Methods: Total of 34 histologically proven primary bone tumor were retrospectively studied which included 25 males and 9 females who received limb salvage surgery for bone tumors at department of surgical oncology, Rajiv Gandhi Government general hospital, Madras medical college, Chennai.
Results: Median age at diagnosis was 23 years. Tumor localized to lower limb in 23 patients, and upper limb in 9 patients, pelvic bones in 3 cases. Tumors were malignant in 24 patients (70.4%) and benign in 10 patients (29.4%). The most common diagnosis was osteosarcoma17 patients (50%). The median resection length was 10 cm. High grade tumors (grade 2a and 2b and grade 3) was found in 14 cases (41.1%). 6 patients had prosthesis related complications. The mean follow-up was 5 years (range: 3-7). 27 (79.4%) patients of 34 were alive with the endo-prosthesis at the last follow-up.
Conclusions: The custom mega prosthesis favored by us in most of the cases in limb sparing surgery for bone tumors results in satisfactory results in terms of local tumor control and limb function.
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References
Enneking WF. An abbreviated history of orthopaedic oncology in North America. Clin Orthop. 2000;374: 115-24
Eckardt JJ, Yang RS, Ward WG, Kelly C, Eilber FR. Endoprosthetic reconstruction for malignant bone tumors and nonmalignant tumorous conditions of bone. In: Stauffer RN, Erlich MG, Fu FH, Kostuik JP, Manske PR, Sim FH, eds. Advances in operative orthopaedics, 3rd ed. USA: Mosby; 1995:61-83.
Choong PF, Sim FH. Limb-sparing surgery for bone tumors: new developments. Semin Surg Oncol. 1997; 13:64-9.
Ries LAG, Smith MA, Gurney JG. Cancer incidence and survival among children and adolescents: United States SEER program 1975-1995. Available at: http://seer.cancer.gov/publications/childhood/. Accessed on 20 November 2023.
Link MP, Eilber F. Osteosarcoma. In: Pizzo PA, Poplack DG, eds. Principles and practice of pediatric oncology, 3rd ed. Philadelphia: Lippincott-Raven; 1997:889-920.
Weis LD. Common malignant bone tumors: Osteosarcoma. In: Simon MA, Springfield D, eds. Surgery for bone and soft tissue tumors. Philadelphia: Lippincott-Raven; 1998:265-74.
Ebeid W, Amin S, Abdelmegid A. Limb salvage management of pathologic fractures of primary malignant bone tumors. Cancer Control. 2005;12:57-61.
Kim SY, Helman LJ. Strategies to explore new approaches in the investigation and treatment of osteosarcoma. Cancer Treat Res. 2009;152:517-28.
Sluga M, Windhager R, Lang S, Heinzl H, Bielack S, Kotz R. Local and systemiccontrol after ablative and limb sparing surgery in patients with osteosarcoma. Clin Orthop. 1999;358:120-7.
Simon MA, Aschliman MA, Thomas N, Mankin HJ. Limbsalvage treatment versus amputation for osteosarcoma of the distal end of the femur. J Bone Joint Surg Am. 2005;87:2822.
Biermann JS, Adkins D, Benjamin R. Bone cancer. J Natl Compr Canc Netw. 2007;5:420-37.
Mankin HJ, Hornicek FJ, Rosenberg AE, Harmon DC, Gebhardt MC. Survival data for 648 patients with osteosarcoma treated at one institution. Clin Orthop Relat Res. 2004;429:286-91.
Bacci G, Ferrari S, Lari S. Osteosarcoma of the limb: amputation or limb salvage in patients treated by neoadjuvant chemotherapy. J Bone Joint Surg Br. 2002;84:88-92.
Enneking WF, Shirley PD. Resection-arthrodesis for malignant and potentially malignant lesions about the knee using an intramedullary rod and local bone grafts. J Bone Joint Surg Am. 1997;59:223-36.
Weinberg H, Kenan S, Lewis MM. The role of microvascular surgery in limb-sparing procedures for malignant tumors of the knee. Plast Reconstr Surg. 1993;92:692-8.
Marulanda GA, Henderson ER, Johnson DA, Letson GD, Cheong D. Orthopedic surgery options for the treatment of primary osteosarcoma. Cancer Control. 2008;15:13-20.
Gebhardt MC, Flugstad DI, Springfield DS. The use of bone allografts for limb salvage in high-grade extremity osteosarcoma. Clin Orthop Relat Res. 1991; 270:181-96.
Sim FH, Frassica FJ. Use of allografts following resection of tumors of the musculoskeletal system. Instr Course Lect. 1993;42:405-13.
Bradish CF, Kemp HB, Scales JT, Wilson JN. Distal femoral replacement by custom-made prostheses, Clinical follow-up and survivorship analysis. J Bone Joint Surg Br. 1987;69:276-84.
Neel MD, Letson GD. Modular endoprostheses for children with malignant bone tumors. Cancer Control. 2001;8:344-8.
Zehr RJ, Enneking WF, Scarborough MT. Allograft prosthesis composite versus megaprosthesis in proximal femoral reconstruction. Clin Orthop. 1996; 322:207-23.
Kabukcuoglu Y, Grimer RJ, Tillman RM, Carter SR. Endoprosthetic replacement for primary malignant tumors of the proximal femur. Clin Orthop. 1999; 358:8-14.
Farid Y, Lin PP, Lewis VO, Yasko AW. Endoprosthetic and allograft-prosthetic composite reconstruction of the proximal femur for bone neoplasms. Clin Orthop Relat Res. 2006;442:223-9.
Malawer MM, Chou LB. Prosthetic survival and clinical results with use of large-segment replacements in the treatment of high-grade bone sarcosarcomas. J Bone Joint Surg Am. 1995;77:1154-65.
Horowitz SM, Glasser DB, Lane JM, Healey JH. Prosthetic and extremity survivorship after limb salvage for sarcoma: how long do the reconstructions last? Clin Orthop. 1993;293:280-6.
Lindner NSJ, Ramm O, Hillmann A. The University of Muenster experience. Clin Orthop Relat Res. 1999; 358:83-9.
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