The Surgical Treatment and Outcome of Nonmetastatic Extremity Osteosarcoma with Pathological Fractures  

作　　者：Zhi-Ping Deng Yi Ding Ajay Puri Edward H M Wang Ashish Gulia Claire Durban Xiao-Hui Niu 

机构地区：[1]Department of Orthopaedic Oncology Surgery,Beijing Ji Shui Tan Hospital,Peking University,Beijing 100035,China [2]Department of Orthopaedic Oncology,Tata Memorial Hospital,Mumbai,Maharashtra 400012,India [3]Department of Orthopaedics,Philippine General Hospital,University of the Philippines,Manila 1000,Philippines

出　　处：《Chinese Medical Journal》2015年第19期2605-2608,共4页中华医学杂志（英文版）

摘　　要：Background：Recent studies have suggested that the presence of a pathological fracture does not impact on oncologic outcomes and the feasibility of limb salvage surgery （LSS） in appropriately selected patients when combined with neoadjuvant chemotherapy.These have largely been single institutional studies with limited numbers.The Eastern Asian Musculoskeletal Oncology Group reviewed the data from three large volume Asian orthopedic oncology centers to determine whether the presence of a pathologic fracture affected outcomes in osteosarcoma patients.Methods：A retrospective review of the data was conducted.Ninety-five cases ofnonmetastatic extremity osteosarcoma with a pathological fracture and 887 cases without fracture treated during the same period were compared.Results：In the fracture group,the LSS rate was 62.1％,and the rate of amputation was 37.9％.In the nonfracture group,the LSS rate was 74.7％,and the amputation was 25.3％.In patients with a pathologic fracture,the rate of local recurrence for LSS and amputation groups was 8.5％ and 2.8％,respectively.In this group,the 5-year survival in the LSS group was 66％ as against.46.8％ in the amputation group.Conclusions：Our study suggests that surgically treated patients with pathologic fractures in osteosarcoma have adequate local control and do not have a poorer outcome compared to patients without a fracture.Though osteosarcoma with a pathologic fracture is not a contraindication for limb salvage,appropriate case selection is important when deciding local control options to ensure adequate oncologic clearance.Background：Recent studies have suggested that the presence of a pathological fracture does not impact on oncologic outcomes and the feasibility of limb salvage surgery （LSS） in appropriately selected patients when combined with neoadjuvant chemotherapy.These have largely been single institutional studies with limited numbers.The Eastern Asian Musculoskeletal Oncology Group reviewed the data from three large volume Asian orthopedic oncology centers to determine whether the presence of a pathologic fracture affected outcomes in osteosarcoma patients.Methods：A retrospective review of the data was conducted.Ninety-five cases ofnonmetastatic extremity osteosarcoma with a pathological fracture and 887 cases without fracture treated during the same period were compared.Results：In the fracture group,the LSS rate was 62.1％,and the rate of amputation was 37.9％.In the nonfracture group,the LSS rate was 74.7％,and the amputation was 25.3％.In patients with a pathologic fracture,the rate of local recurrence for LSS and amputation groups was 8.5％ and 2.8％,respectively.In this group,the 5-year survival in the LSS group was 66％ as against.46.8％ in the amputation group.Conclusions：Our study suggests that surgically treated patients with pathologic fractures in osteosarcoma have adequate local control and do not have a poorer outcome compared to patients without a fracture.Though osteosarcoma with a pathologic fracture is not a contraindication for limb salvage,appropriate case selection is important when deciding local control options to ensure adequate oncologic clearance.

关 键 词：FRACTURE Local Recurrence OSTEOSARCOMA SURVIVAL 

分 类 号：S858.292[农业科学—临床兽医学] TH781[农业科学—兽医学]