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骨肉瘤:治疗管理概述,重点关注手术治疗的考虑因素。

Bone sarcomas: Overview of management, with a focus on surgical treatment considerations.

机构信息

Director, Musculoskeletal Tumor Center, Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A41, Cleveland, OH 44195, USA.

出版信息

Cleve Clin J Med. 2010 Mar;77 Suppl 1:S8-12. doi: 10.3949/ccjm.77.s1.02.

Abstract

Outcomes for patients with bone sarcomas have improved dramatically over the past 40 years, and most bone sarcomas today are treated with surgery and chemotherapy. The most common clinical findings in patients with bone sarcomas are pain and an enlarging bone mass, although pain is not generally a good indicator of malignancy. In general, any patient with a bone mass with indeterminate imaging findings should be referred to an orthopedic oncologist. Bone sarcomas are diagnosed after a biopsy, which is best performed by the surgeon who will be doing the curative resection. Postresection reconstruction of the affected limb is generally done with an allograft-prosthetic composite or a modular metallic prosthetic joint replacement device. Post-therapy follow-up at frequent and regular intervals is critical to assess for recurrence and lung metastasis.

摘要

过去 40 年来,患有骨肉瘤的患者的预后得到了显著改善,如今大多数骨肉瘤患者都接受了手术和化疗。骨肉瘤患者最常见的临床发现是疼痛和不断增大的骨块,尽管疼痛通常不是恶性肿瘤的良好指标。一般来说,任何有不确定影像学发现的骨块患者都应转介给骨科肿瘤医生。骨肉瘤是在活检后诊断的,活检最好由将要进行根治性切除的外科医生进行。受影响肢体的切除后重建通常采用同种异体移植物-假体复合或模块化金属假体关节置换装置。在频繁和定期的间隔进行治疗后随访对于评估复发和肺转移至关重要。

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