En bloc resection for osteogenic sarcoma.

Preservation of a limb without sacrifice of the principles of cancer surgery is desirable in young people with osteogenic sarcoma. At present amputation is generally regarded as the only well-established curative treatment for this condition. To determine whether en bloc resection with intensive chemotherapy is a realistic alternative to radical amputation and chemotherapy, 43 patients who underwent en bloc resection for osteogenic sarcoma of the distal femur (20 patients), proximal tibia (11 patients), shoulder girdle (11 patients) and fibula (1 patient) were studied. After tumour resection, chemotherapy and pulmonary resection 32 (74%) of the 43 patients are alive and 20 (67%) have no evidence of distant disease. Of the 38 patients without metastatic disease at the time of admission (5 were admitted with pulmonary metastases) 24 (63%) are alive without evidence of disease and without having had postoperative metastases.