Amino K, Noriyoshi K, Matsumoto S, Manabe J, Furuya K, Isobe Y
Dept. of Orthopedic Surgery, Cancer Institute Hospital.
Gan To Kagaku Ryoho. 1988 Apr;15(4 Pt 2-3):1488-94.
Since 1977 we have treated 18 bone sarcomas and 16 soft tissue sarcomas of the shoulder part. For 10 bone sarcomas of the proximal humerus, four fore-quarter amputations, two curative wide resections, and four wide excisions were performed as radical operations. The reconstructive procedures after the six resections were two spacer insertions, one total shoulder replacement, and three arthrodeses with autografts. Considering the functional result, the arthrodesis is the most-recommended method. For eight bone sarcomas of the scapula, three total resections and four partial resections of the scapula, and one debulking operation were performed. For 16 soft tissue sarcomas, we performed two ablative operations, three curative wide resections, five wide excisions, and six conservative operations after adjunctive chemo-and/or radiotherapy. Among all 34 bone and soft tissue sarcomas, the success rate for limb salvage was 74%, while the recurrence rate was 18%. The functional result of the limb salvage operations was far better than that of ablative operations of the shoulder part. In fact the rate of satisfactory ADL (excellent and good) was 81% among the limb salvage cases, while for ablative operations, the ADL ratings were all poor.
自1977年以来，我们共治疗了18例肩部骨肉瘤和16例肩部软组织肉瘤。对于10例肱骨近端骨肉瘤，作为根治性手术进行了4例前半截肢术、2例根治性广泛切除术和4例广泛切除术。6例切除术后的重建手术包括2例间隔物植入术、1例全肩关节置换术和3例自体骨移植关节融合术。考虑到功能结果，关节融合术是最推荐的方法。对于8例肩胛骨骨肉瘤，进行了3例肩胛骨全切除术、4例肩胛骨部分切除术和1例减瘤手术。对于16例软组织肉瘤，我们在辅助化疗和/或放疗后进行了2例切除手术、3例根治性广泛切除术、5例广泛切除术和6例保守手术。在所有34例骨肉瘤和软组织肉瘤中，保肢成功率为74%，复发率为18%。保肢手术的功能结果远优于肩部切除手术。事实上，保肢病例中ADL（优秀和良好）满意度为81%，而切除手术的ADL评分均较差。
