Yoshikawa H, Araki N, Ueda T, Kato T, Uchida A, Ono K, Hamada H, Aoki Y
Dept. of Orthopaedic Surgery, Osaka University Medical School.
Gan To Kagaku Ryoho. 1989 Apr;16(4 Pt 2-3):1744-8.
Recent advances in therapy such as local and systemic chemotherapy, wide resection, and aggressive thoracotomy improved the survival of the patients with malignant bone tumors. Since 1981, we have performed limb-salvage operations for 54 cases of malignant bone tumors of the extremities. In this study, we report the rate of local recurrence and the prognosis of the patients. We treated 37 osteosarcomas, 8 malignant fibrous histiocytomas of bone, 3 Ewing's sarcomas, 3 parosteal osteosarcomas, 2 chondrosarcomas, and one fibrosarcoma. The age of the patients ranged from 11 to 65 years (mean, 18.5). The male/female ratio was 2:1. The surgical stage was 47 at II B and 7 at III. The follow-up period was 14 to 84 months (mean 36). They received preoperative chemotherapy including intraarterial infusion of Adriamycin, and postoperative chemotherapy for ten months. Local recurrence was detected in 2/54 (3.7%). Lung metastases (Stage II B) developed in 9/47 (19.1%). Five of them (10.7%) died of metastasis, one is alive with metastases, and 41 cases are now disease-free. Six of seven cases (Stage III) died of metastasis, despite aggressive chemotherapy and thoracotomies.
近年来，局部和全身化疗、广泛切除以及积极的开胸手术等治疗方法的进展提高了恶性骨肿瘤患者的生存率。自1981年以来，我们对54例四肢恶性骨肿瘤患者进行了保肢手术。在本研究中，我们报告了患者的局部复发率和预后情况。我们治疗了37例骨肉瘤、8例骨恶性纤维组织细胞瘤、3例尤因肉瘤、3例骨旁骨肉瘤、2例软骨肉瘤和1例纤维肉瘤。患者年龄在11岁至65岁之间（平均18.5岁）。男女比例为2:1。手术分期为II B期47例，III期7例。随访时间为14至84个月（平均36个月）。他们接受了包括动脉内灌注阿霉素在内的术前化疗以及为期十个月的术后化疗。54例中有2例（3.7%）出现局部复发。47例中有9例（19.1%）发生肺转移（II B期）。其中5例（10.7%）死于转移，1例带转移存活，41例目前无病。7例III期患者中有6例尽管接受了积极的化疗和开胸手术，但仍死于转移。
