Ayerza Miguel A, Muscolo D Luis, Aponte-Tinao Luis A, Farfalli German
Institute of Orthopedics, Carlos E. Ottolenghi Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
Clin Orthop Relat Res. 2006 Nov;452:231-5. doi: 10.1097/01.blo.0000229314.58878.88.
To determine whether inappropriate surgical procedures based on an initial misdiagnosis affected recurrence and survival rates, we retrospectively reviewed the surgical treatment and results of 117 patients with high-grade osteosarcomas treated from January 1, 1990 to December 31, 2000. Nine patients had intralesional curettage performed at other institutions based on an erroneous diagnosis of a benign lesion. Two of the nine patients had amputations and seven patients had limb-salvage procedures. Of the 108 patients who were not misdiagnosed, six patients had amputations and 102 patients had limb-salvage procedures. All patients received neoadjuvant therapy. Fifteen of the 117 patients had local recurrences. Patients who had erroneous surgical procedures based on the initial misdiagnosis of osteosarcoma had an increased risk of local recurrence and decreased 10-year survival rate. Response to adjuvant therapy and the amount of previous violation of natural tumor barriers should be evaluated carefully before deciding surgical treatment.
为了确定基于初始误诊的不恰当手术程序是否会影响复发率和生存率，我们回顾性分析了1990年1月1日至2000年12月31日期间接受治疗的117例高级别骨肉瘤患者的手术治疗情况及结果。9例患者因被错误诊断为良性病变而在其他机构接受了病灶内刮除术。这9例患者中，2例行截肢术，7例行保肢手术。在108例未被误诊的患者中，6例行截肢术，102例行保肢手术。所有患者均接受了新辅助治疗。117例患者中有15例出现局部复发。基于骨肉瘤初始误诊而进行错误手术程序的患者局部复发风险增加，10年生存率降低。在决定手术治疗之前，应仔细评估辅助治疗的反应以及先前对天然肿瘤屏障的破坏程度。
