The Clinical Efficacy Analysis Of Neoadjuvant Chemotherapy Combined With Limb-salvage Surgery For The Treatment Of Osteosarcoma And The Evaluation Of Postoperative Complications And Functions Of Patients With Different Operation Methods

Objective:1.To evaluate the clinical efficacy of limb-salvage treatment and amputation in patients with osteosarcoma.2.To evaluate the clinical effect of different surgical methods on osteosarcomaMethods:1.Study subjects: patients with limb osteosarcoma diagnosed by bone oncology department of the second hospital of shanxi medical university from December 2010 to June 2017,collected patients’ clinical case imaging data and regularly followed up.2.Treatment methods: preoperative biopsy confirmed for Enneking stage four limbs which sarcoma,preoperative specification neoadjuvant chemotherapy to two period of treatment,chemotherapy over two weeks after surgery(limb-salvage surgery or amputation),take out stitches after two weeks began to adjuvant chemotherapy after four treatment,chemotherapy dose intensity with neoadjuvant chemotherapy regimens.3.Survival in patients with regular follow-up and record the presence of infection postoperative local recurrence and distant metastasis,and in accordance with the ISOLS(International Society of Limb Salvage)conference and recommended by American Society for bone and soft tissue tumor postoperative functional reconstruction evaluation system for 6 months and 18 months postoperatively in patients with Limb function score.4.According to the group and limb-salvage surgery is divided into amputation,limb-salvage group is divided into tumor prosthesis replacement group and tumor segment inactivated replantation,with the 5-year survival rate for 5 years distant metastasis rate and postoperative functional recovery evaluation index respectively,the amputation group and limb-salvage prosthetic replacement group compared with tumor segment inactivated group,and the prosthetic replacement and tumor inactivated group compared the incidence of local recurrence of infection.5.Statistical analysis: use SPSS16.0 software for data processing Normal distribution of measurement data with mean standard deviation(χ s)to represent the functional score between the two groups to compare using independent sample t test by percentage counting data,using chi-square test comparing group of local recurrence rates between local infection Kaplan Meier-survival curve drawing,group 5 years cumulative survival rate and the distance between the log-rank 5 years transfer rate test p < 0.05 for the difference was statistically significant(p < 0.1 for the difference was statistically trend.Results:1.Kaplan-Meier method showed no significant difference in 5-year survival and distant metastasis after amputation and limb preservation(P > 0.05).The functional scores of 6and 18 months were better than those of the amputee group(P <0.05).2.Kaplan-Meier method showed no significant difference in 5-year survival rate and distant metastasis after prosthesis replacement and tumor section inactivated replantation(P > 0.05).3.The local recurrence rate and postoperative infection risk were higher than that of tumor prosthesis(P<0.05).4.Patients in inactivated tumor group with short period of time(6 months)after functional reconstruction score(P<0.05),The functional improvement of 18 months after operation was even stronger than that of prosthesis replacement group(0.05<P<1).Conclusion:The 5-year survival rate and distant metastasis rate were not affected by different operation methods.Amputation is better than amputation.The local recurrence rate and postoperative infection rate were higher in inactivated group and the short-term functional recovery was poor.Amputation is better than amputation,and tumor prosthesis replacement is better than tumor section inactivated replantation.