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Titolo:
LIMB SALVAGE SURGERY FOR PRIMARY BONE SARCOMA OF THE LOWER-EXTREMITIES - LONG-TERM CONSEQUENCES OF ENDOPROSTHETIC RECONSTRUCTIONS
Autore:
HAM SJ; KOOPS HS; VETH RPH; VANHORN JR; MOLENAAR WM; HOEKSTRA HJ;
Indirizzi:
UNIV GRONINGEN HOSP,DEPT SURG ONCOL,POB 30-001 NL-9700 RB GRONINGEN NETHERLANDS UNIV GRONINGEN HOSP,DEPT SURG ONCOL NL-9700 RB GRONINGEN NETHERLANDS UNIV GRONINGEN HOSP,DEPT ORTHOPAED NL-9700 RB GRONINGEN NETHERLANDS UNIV GRONINGEN HOSP,DEPT PATHOL NL-9700 RB GRONINGEN NETHERLANDS
Titolo Testata:
Annals of surgical oncology
fascicolo: 5, volume: 5, anno: 1998,
pagine: 423 - 436
SICI:
1068-9265(1998)5:5<423:LSSFPB>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY OSTEOGENIC-SARCOMA; EN BLOC RESECTION; ADJUVANT CHEMOTHERAPY; PREOPERATIVE CHEMOTHERAPY; DELAYED SURGERY; PROXIMAL FEMUR; REPLACEMENT; TUMORS; OSTEOSARCOMA; METASTASES;
Keywords:
LIMB SALVAGE; MULTIMODALITY THERAPY; BONE SARCOMA; ENDOPROSTHETIC REPLACEMENT; CEMENTLESS FIXATION; REVISIONAL SURGERY; LONG-TERM SURVIVAL; LOCAL RECURRENCE; CANCER SURVIVORSHIP;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
55
Recensione:
Indirizzi per estratti:
Citazione:
S.J. Ham et al., "LIMB SALVAGE SURGERY FOR PRIMARY BONE SARCOMA OF THE LOWER-EXTREMITIES - LONG-TERM CONSEQUENCES OF ENDOPROSTHETIC RECONSTRUCTIONS", Annals of surgical oncology, 5(5), 1998, pp. 423-436

Abstract

Background: Adjuvant chemotherapy and endoprosthetic replacement for bone sarcomas of the lower extremity is well established. The specificlong-term consequences of these endoprosthetic reconstructions for the patient's affected limb are unknown. Method: The oncologic results and the survival of the endoprostheses were reviewed in 32 patients with primary bone sarcoma of the femur or proximal tibia. There were 26 high-grade sarcomas, and 6 low-grade sarcomas. A proximal femoral endoprosthesis was used for reconstruction in 4 patients, a total or push-through femoral endoprosthesis in 11 patients, a distal femoral endoprosthesis in 15 patients, and a proximal tibial endoprosthesis in two patients. Results: Median survival was 10 years (range, 1.1 to 18.9 years) for patients with high-grade sarcoma, and 8.1 years (range, 7.1 to 10 years) for patients with low-grade sarcomas. Distant metastases developed in seven patients (22%), all with stage IIB sarcoma, with concomitant local recurrence in 3 patients (9%). Five-year overall and disease-free survival rates for high-grade sarcomas were 81% and 73%, respectively. The overall endoprosthetic survival rate was 87% at 5 years,80% at 10 years, and 56% at 15 years. Median follow-up of the original endoprostheses was 8.3 years (range, 0.6 to 18.7 years). Endoprosthesis-related complications occurred in 13 patients (41%); most complications were mechanical failures. The highest complication rate was found in distal femoral replacements (60%); amputation was necessary in both patients treated with a proximal tibial endoprosthesis. Five endoprostheses (16%) were revised. An amputation of the involved limb was performed in four patients (13%): in two patients because of local recurrence and in the other two patients because of infection. For patientsalive at follow-up, the median functional Enneking evaluation score was 22 points (range, 12 to 28 points), with the highest functional scores in patients with a distal femoral endoprosthesis, and the lowest functional scores in patients with total or push-through femoral replacements. Conclusion: Endoprosthetic reconstructions gave satisfying functional results in most patients after long-term survival. However, the proximal tibial and distal femoral endoprosthesis are particularly at risk for long-term endoprosthetic complications requiring additionalsurgical procedures.

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Documento generato il 05/12/20 alle ore 20:07:22