Yin Zhen-Chen, Liu Bing-Gen, Pang Qing-Jiang
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China.
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China;
Zhongguo Gu Shang. 2016 Dec 25;29(12):1140-1145. doi: 10.3969/j.issn.1003-0034.2016.12.015.
To explore 5-year survival rate, local recurrence and metastasis rate of limb salvage and amputation for patients with local Enneking II osteosarcoma by Meta-analysis.
From January 1, 1970 to December 1, 2015, Subject term and keywords about limb salvage and amputation for local Enneking II osteosarcoma with pathological fracture were searched from Cochrane, PubMed, Ovid, Spinger Link, Embase, CNKI and WanFang database foundation. Literature confirm with inclusion criteria were choose and quality evaluation were performed. RevMan 5.0 software from Cochrane collaboration was used to perform Meta-analysis. Local recurrence, 5-year survival rate and odds ratio of transfer risk were compared between limb salvage and amputation group.
Ten literatures confirm with inclusion criteria were included, and total sample size was 453. There were 315 patients in limb salvage group and 138 patients in amputation group. Five-year survival rate in amputation group was lower than that of limb salvage group [OR=2.88, 95%CI(1.40, 5.93)], however metastasis rate in limb salvage was less than that of amputation group [OR=0.43, 95%CI(0.20, 0.94)];there were no significant differences in local recurrence between two groups [OR=1.47, 95%CI (0.73, 2.97)]. Functional rehabilitation in limb salvage group was better than that of amputation group by MSTS systematic review.
Limb salvage as an alternative in treating local Enneking II osteosarcoma with pathological fracture does not greatly increase risk of local recurrence or 5-year overall survival rate compared with amputation group, and has a lower risk of metastatic occurrence.
通过Meta分析探讨局部Enneking II期骨肉瘤患者保肢术与截肢术的5年生存率、局部复发率及转移率。
检索1970年1月1日至2015年12月1日期间Cochrane、PubMed、Ovid、Spinger Link、Embase、中国知网和万方数据库中关于局部Enneking II期骨肉瘤合并病理性骨折的保肢术与截肢术的主题词和关键词。选择符合纳入标准的文献并进行质量评估。采用Cochrane协作网的RevMan 5.0软件进行Meta分析。比较保肢组与截肢组的局部复发率、5年生存率及转移风险比值比。
纳入10篇符合纳入标准的文献，总样本量为453例。保肢组315例，截肢组138例。截肢组5年生存率低于保肢组[OR=2.88，95%CI(1.40, 5.93)]，然而保肢组的转移率低于截肢组[OR=0.43，95%CI(0.20, 0.94)]；两组局部复发率差异无统计学意义[OR=1.47，95%CI (0.73, 2.97)]。MSTS系统评价显示保肢组的功能康复情况优于截肢组。
对于合并病理性骨折的局部Enneking II期骨肉瘤患者，与截肢术相比，保肢术作为一种治疗选择不会显著增加局部复发风险或5年总生存率，且转移发生风险较低。
