Colomina Jordi, Peiro Ana, Trullols Laura, Garcia Isidre
Department of Oncologic Orthopaedic Surgery, Hospital de Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Spain.
J Orthop Surg (Hong Kong). 2013 Apr;21(1):96-9. doi: 10.1177/230949901302100124.
To review records of 8 patients with telangiectatic osteosarcoma (TOS) and determine whether pathologic fractures correlate with recurrence and survival.
Records of 4 men and 4 women aged 17 to 44 (mean, 28) years treated for TOS were reviewed. RESULTS; Of the 8 patients, 4 developed a pathologic fracture and 4 did not. In each group, 2 patients underwent limb salvage surgery and 2 underwent amputation. All patients received neoadjuvant and adjuvant chemotherapy with a combination of at least 2 of the following drugs: doxorubicin, methotrexate, cisplatin, and vincristin. After a mean follow-up of 5.6 (range, 2-16) years, all 4 patients with a pathologic fracture and 2 of the 4 patients without a pathologic fracture were still alive and disease-free. For the remaining patients, one died after 31 months from progression of a lung metastasis, and the other was alive with the disease and had had 2 recurrences, a lung metastasis, and an infection with Klebsiella oxytoca that eventually led to an amputation.
The presence of a pathologic fracture in patients with TOS was not associated with worse outcome in terms of recurrence and survival.
回顾8例毛细血管扩张性骨肉瘤(TOS)患者的记录,确定病理性骨折是否与复发和生存相关。
回顾了4例男性和4例女性TOS患者的记录,年龄在17至44岁(平均28岁)。结果:8例患者中,4例发生了病理性骨折,4例未发生。每组中,2例患者接受了保肢手术,2例接受了截肢手术。所有患者均接受了新辅助化疗和辅助化疗,联合使用以下至少2种药物:阿霉素、甲氨蝶呤、顺铂和长春新碱。平均随访5.6年(范围2至16年)后,所有4例发生病理性骨折的患者和4例未发生病理性骨折患者中的2例仍存活且无疾病。其余患者中,1例在31个月后因肺转移进展死亡,另1例存活但患有疾病,有2次复发、1次肺转移以及产酸克雷伯菌感染,最终导致截肢。
TOS患者病理性骨折的存在与复发和生存方面的较差预后无关。