The Limb-salvage Treatment Of Limb Osteosarcoma A Clinical Outcome Study

Objective:To evaluate the outcome of limb-salvage and amputation surgery combined with chemotherapy for stage II osteosarcoma of extremities.Methods: A analysis was conducted on clinical data from 68 patients with osteosarcoma of extremities undergoing surgical operations from 1996 to 2007.Among them, 48 patients received limb-salvage surgery (21 patients received bone tumor resection and devitalized tumor bone reimplantation,24 prosthetic replacement ,2 bone tumor resection for osteosarcoma in proximate fibula,l bone tumor resection for osteosarcoma in distant radial and fibula grafting and fixation.) and 20 patients underwent amputation. Preopeative and postoperative chemotherapy were performed in 68 patients.53 patients (full information) were devided into limb-salvage treatment group and amputation treatment group. The two groups were compared with 3-year survival ,local recurrence rate and the functional evaluation of reconstructive procedures. Compared with log-rank test ,P<0.05 means significant difference.Results:Among 53 patient (full information) ,in limb-salvage surgery group ,the proportion of patients with 3-year survival was 51.4%,local recurrence rate was 8%(<10%),and the functional evaluation of reconstructive procedures after surgical treatment was satisfactory (26 cents) .In amputation patients,the proportion of patients with 3-year survival was 50%,local recurrence rate was 6%,and the functional evaluation of reconstructive procedures after surgical treatment was 12 cents. There was no significant difference between the two groups in the proportion of patients with 3-year survival (P>0.05).Conclusion:Combined with preoperative and postoperative chemotherapy, limb-salvage and amputation surgery would lead to a similar 3-year survival outcome. Limb-salvage surgery could retain the function of reconstructive extremity after bone tumor resection for osteosarcoma. In accordence with limb-salvage surgery demand , patients with osteosarcoma of extremities could be extended life and retained the function of lesion sites.