Oncol Res Treat. 2017;40(9):528-532. doi: 10.1159/000477251. Epub 2017 Aug 22.
We aimed to explore the clinical effects and prognosis of different surgical methods in upper tibia osteosarcoma.
Among 112 patients with proximal upper tibia osteosarcoma, 40 patients were treated with amputation, 20 patients were treated with massive osteoarticular allograft, and the remaining 52 cases were treated with tumor resection and artificial joint replacement.
Recurrence was observed in 2 cases (5%) in the amputation group, in 6 cases (30%) in the massive osteoarticular allograft group, and in 6 cases (12%) in the tumor resection and artificial joint replacement group (P = 0.021). The lung metastasis rates were 40% in the amputation group, 40% in the massive osteoarticular allograft group, and 38% in the tumor resection and artificial joint replacement group (P = 0.986). The survival rates at 1, 3, and 5 years were 95%, 75%, and 45%, respectively, in the amputation group, 95%, 75%, and 35%, respectively, in the massive osteoarticular allograft group, and 92.3%, 78.8%, and 53.8%, respectively, in the tumor resection and artificial joint replacement group (P > 0.05).
The selection of the optimal surgical method for upper tibia osteosarcoma should be made according to the individual circumstances of the patient. Our study has significance for reducing the incidence of surgical complications and improving the quality of postoperative life.
本研究旨在探讨不同手术方法在上胫骨骨肉瘤中的临床效果和预后。
112 例胫骨近端骨肉瘤患者中，40 例行截肢术，20 例行大块异体骨关节移植术，52 例行肿瘤切除和人工关节置换术。
截肢组复发 2 例（5%），大块异体骨关节移植组复发 6 例（30%），肿瘤切除和人工关节置换组复发 6 例（12%）（P = 0.021）。截肢组肺转移率为 40%，大块异体骨关节移植组为 40%，肿瘤切除和人工关节置换组为 38%（P = 0.986）。截肢组 1、3、5 年生存率分别为 95%、75%、45%，大块异体骨关节移植组分别为 95%、75%、35%，肿瘤切除和人工关节置换组分别为 92.3%、78.8%、53.8%（P>0.05）。
选择合适的手术方法应根据患者的具体情况而定。本研究对降低手术并发症的发生率，提高术后生活质量有重要意义。
