Similar Survival but Better Function for Patients after Limb Salvage versus Amputation for Distal Tibia Osteosarcoma

Mavrogenis, Andreas F.; Abati, Caterina Novella; Romagnoli, Carlo; Ruggieri, Pietro

doi:10.1007/s11999-011-2238-7

Cited by 93 publications

(130 citation statements)

References 38 publications

(201 reference statements)

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“…The main complications include infection, fracture, nonunion, loosening, and so on. Amputation does not have the above complications, so it still has some value in the treatment of osteosarcoma [21].…”

Section: Discussionmentioning

confidence: 99%

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Selection of Surgical Methods in the Treatment of Upper Tibia Osteosarcoma and Prognostic Analysis

et al. 2017

Oncol Res Treat

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Background: We aimed to explore the clinical effects and prognosis of different surgical methods in upper tibia osteosarcoma. Methods: Among 112 patients with proximal upper tibia osteosarcoma, 40 patients were treated with amputation, 20 patients were treated with massive osteoarticular allograft, and the remaining 52 cases were treated with tumor resection and artificial joint replacement. Results: Recurrence was observed in 2 cases (5%) in the amputation group, in 6 cases (30%) in the massive osteoarticular allograft group, and in 6 cases (12%) in the tumor resection and artificial joint replacement group (P = 0.021). The lung metastasis rates were 40% in the amputation group, 40% in the massive osteoarticular allograft group, and 38% in the tumor resection and artificial joint replacement group (P = 0.986). The survival rates at 1, 3, and 5 years were 95%, 75%, and 45%, respectively, in the amputation group, 95%, 75%, and 35%, respectively, in the massive osteoarticular allograft group, and 92.3%, 78.8%, and 53.8%, respectively, in the tumor resection and artificial joint replacement group (P > 0.05). Conclusions: The selection of the optimal surgical method for upper tibia osteosarcoma should be made according to the individual circumstances of the patient. Our study has significance for reducing the incidence of surgical complications and improving the quality of postoperative life.

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Section: Discussionmentioning

confidence: 99%

“…The MSTS scores at 6 months post operation were 10.60 ± 1.65 (7)(8)(9)(10)(11)(12)(13) in the amputation group, 22.45 ± 1.82 (19)(20)(21)(22)(23)(24)(25)(26) in the massive osteoarticular allograft group, and 25.23 ± 1.17 (22)(23)(24)(25)(26)(27) in the tumor resection and artificial joint replacement group (table 2).…”

Section: Function Outcomesmentioning

confidence: 99%

Selection of Surgical Methods in the Treatment of Upper Tibia Osteosarcoma and Prognostic Analysis

et al. 2017

Oncol Res Treat

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“…Over the course of the 1950s, while the five-year survival rates initially were around 20% and amputation was the first choice in extremity malignant tumors, the rates increased to 60-70% through use of adjuvant chemotherapy and radiotherapy, and amputation was replaced with limb salvage surgery (LSS) [5][6][7]. While LSS has advantages such as reconstruction stability and functionality, it also has disadvantages such as fractures and fixation loss [8].…”

Section: Discussionmentioning

confidence: 99%

Analysis of 24 Patients Who Were Amputated Due to a Malignant Tumor in the Skeleton

Göçer¹

2016

Ann Clin Anal Med

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ÖzetAmaç: Kliniğimizde primer malign ve metastatik kemik ve yumuşak doku tü-mörü nedeniyle amputasyon uygulanan olguların değerlendirilmesi amaçlan-dı. Gereç ve Yöntem: Ocak 1987-Ocak 2012 yılları arasında, ekstremite primer malign ve metastatik kemik ve yumuşak doku tümörü nedeniyle amputasyon uygulanan 24 olgu retrospektif olarak incelendi. Olgular yaş, cinsiyet, patolojik tanı, lokalizasyon, amputasyon tipi, sağkalım ve özellikleri açısın-dan değerlendirildi. Elde edilen veriler SPSS 15.0 sistemine aktarılarak analiz edildi. Verilerin normal dağılıma uyup uymadığı Shapiro-Wilk testi ile değer-lendirildi. Bulgular: 24 olgunun 17'si (%70) erkek, 7'si (%30) kadın ve yaş ortalaması 42 (12-68) yıl idi. En sık cilt kanseri (%25), Ewing sarkomu (%20.8), Osteosarkom (%16.6) ve diğerleri (Malign mezenkimal tümör, kodrosarkom, sinovial sarkom, metastatik tümör) nedeniyle amputasyon yapıldığı görüldü. 24 hastanın 16'sı en az bir defa farklı merkezde daha önce müdahale edildiği görüldü. En sık diz üstü amputasyon (%58.3), diz altı amputasyon (%25), ve diğerleri (kalça dezartikülasyonu, dirsek altı amputasyon) uygulandı. 8 hastada cilt problemleri görüldü ve 6'sına debridman yapıldı. Postoperatif ilk bir yıl içinde 14 olgunun kaybedildiği gözlendi. Tartışma: Hastanın diğer sağlık sorunlarının tedavisi ve ileri evre malign ekstremite tümörlerinin hızlı ve lokal kontrolü için amputasyon yapılabilir. Anahtar KelimelerMalign Tümör; Primer; Metastatik; Cerrahi; Amputasyon Abstract Aim: The purpose of the study was to assess the cases that were amputated in our clinic due to primary malignant and metastatic bone and soft tissue tumor. Material and Method: 24 cases that were amputated due to primary malignant and metastatic bone and soft tissue tumor between January 1987 and January 2012 were examined retrospectively. The cases were assessed in terms of age, gender, pathological diagnosis, localization, type of amputation, survival and characteristics. The data obtained were transferred to SPSS 15.0 program and analyzed. Normality distributions of the data were analyzed with Shapiro-Wilk test. Results: Of the 24 cases, 17 (70%) were men, while 7 (30%) were women and the average age was 42 (between 12 and 68). The most common reasons for amputation were skin cancer (25%), Ewing sarcoma (20.8%), Osteosarcoma (16.6%) and others (Malignant mesenchymal tumor, chondrosarcoma, synovial sarcoma, metastatic tumor). 16 of these patients had previously received an intervention in a different centre at least once. The most common type of amputation was above-knee amputation (58.3%), below-knee amputation (25%) and others (hip disarticulation, below-elbow amputation). 8 patients were found to have skin problems and debridement was performed on 6. 14 cases died within the postoperative first year. Discussion: Amputation can be performed for the treatment of the patient's other health problems and fast and local controls of advanced malignant extremity tumors.

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“…[13,14] Several studies reported the survival rates after limb-salvage range from 100% to 50% at 6-288 months, [15,16] whereas those for amputation range from 100% to 84% at 36-60 months. [4,17] Thus, whether the relapse, 5-year survival and metastasis the same or not between limb-salvage and amputation in the treatment of patients with limited stage EnnekingⅡpathologic fracture osteosarcoma was not known.…”

Section: Discussionmentioning

confidence: 99%

“…[3] Several studies have evaluated the difference between limb-savage surgery and amputation in patients with high-grade no-metastatic osteosarcoma and not shown a significant difference in aspects of survival and local recurrence rate. [3,4] But whether the relapse, 5-year survival and metastasis rate between limb-salvage and amputation in the treatment of patients with limited stage EnnekingⅡ pathologic fracture osteosarcoma patients were not known. Here, we performed this meta-analysis based on published clinical trials to further explore the clinical efficacy between limb-salvage and amputation in the treatment of patients with limited stage EnnekingⅡ pathologic fracture osteosarcoma patients.…”

Section: Introductionmentioning

confidence: 99%

A meta-analysis of limb-salvage versus amputation in the treatment of patients with Enneking‡U pathologic fracture osteosarcoma

Jiang

Shi

et al. 2014

Indian J Cancer

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Similar Survival but Better Function for Patients after Limb Salvage versus Amputation for Distal Tibia Osteosarcoma

Abstract: Level III, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence.

Cited by 93 publications

References 38 publications

Selection of Surgical Methods in the Treatment of Upper Tibia Osteosarcoma and Prognostic Analysis

Selection of Surgical Methods in the Treatment of Upper Tibia Osteosarcoma and Prognostic Analysis

Analysis of 24 Patients Who Were Amputated Due to a Malignant Tumor in the Skeleton

A meta-analysis of limb-salvage versus amputation in the treatment of patients with Enneking‡U pathologic fracture osteosarcoma

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