| Objective:Osteosarcoma is an aggressive malignant neoplasm,and conflicting findings have been re-ported on the survival and function recovery in osteosarcoma patients experiencing limb salvage or amputation.In the present study,we compared clinical outcomes regarding limb salvage surgery vs.amputation for osteosarcoma patients by a meta-analysis to seek the best surgical treatment for patients with osteosarcoma.Methods:Make a suitable search strategy,literature search was conducted according to keywords in CNKI,Medline,Embase,the Cochrane Database,and Web of Sciences,and the quality of included studies was evaluated based on Newcastle-Ottawa scale quality assessment.Odds ratio and 95%confidence interval of the local recurrence,5-year overall survival,and metastasis occurrence were calculated,they are the outcomes for this study.Results:17 articles were included according to selection criteria.There were 1343 patients in total derived from these studies,including 617 patients received Limb-salvage treatment and 726 received amputation.According to NOS quality evaluation criteria,the 17 articles scored more than or equal to 5 points,all of which were high quality literature.The study showed no obvious heterogeneity and publication bias according to the P value and funnel plot of the study.The final results of meta-analysis showed local recurrence rate in the limb salvage group and the amputation group(OR,1.03;95%CI,[0.65-3.30];Z=0.14,P=0.89),5-year overall survival(OR,1.47;95%CI,[1.10-1.97];Z=2.61,P<0.05),metastasis occurrence rate(OR,0.24;95%Cl,[0.10-0.60];Z = 3.5,P<0.05).Our result showed that there was no significant difference between limb salvage surgery and amputation with respect to local recurrence,and patients with limb salvage surgery had a higher 5-year overall survival,and a lower metastasis occurrence.Conclusions:The present study provided more comprehensive evidences to support limb salvage surgery as an optimal treatment of osteosarcoma patients. |
PDF Full Text Request