Comparative Efficacy of Intraoperative Extracorporeal Irradiated and Alcohol Inactivated Autograft Reimplantation in Management of Osteosarcomas– A Multicentre Retrospective Study.

Abstract

Background: The biologic bone reconstruction in the treatment of malignant bone tumours for the limb salvage surgery has always been a controversial strategie. Vary inactivation methods, convenient, stable, curative effect and economy need to be considered. This study aims to compare the clinical efficacy between intraoperative extracorporeal irradiated and alcohol inactivated autograft reimplantation methods for limb salvage surgery with osteosarcomas. Methods: We retrospectively analysed 28 patients with osteosarcomas, 14 patients treated with intraoperative cobalt 60 irradiation and reimplantation treatment (Group A), 14 patients treated by alcohol-inactivated autograft reimplantation (Group B). The postoperative complications and clinical efficacy was compared by statistical analysis. Results: The local recurrence rate was 14.3% in each group. Complete bony union was achieved in 64.3% in group A and 71.4% in group B. The overall 5-year survival rate was 71.4% in group A and 78.6% in group B. The mean MSTS score was 25.33 ± 4.72 (range 15–30 ) in group A and 24.00 ± 5.85 (range 15–30 ) in group B. The mean ISOLS score was 25.79 ± 5.13 (range 20–36 ) in group A and 26.14 ± 5.33 (range 20–30 ) in group B. P < 0.05 was considered to indicate a significant difference, there was no difference in the long-term clinical efficacy between the extracorporeal irradiation and alcohol-inactivated methods.Conclusions: For limb salvage surgery with osteosarcomas, either intraoperative extracorporeal irradiation or alcohol-inactivated autograft repimlantation had equivalent outcomes for biological reconstruction. The alcohol-inactivated technology could be a much more convenient and cheap treatment to reconstruct bone defects. Additional studies and more case studies are needed to fully evaluate the clinical efficacy and safety of the alcohol-inactivated surgical approach.