Missenard G, Dubousset J, Genin J, Contesso G
Rev Chir Orthop Reparatrice Appar Mot. 1986;72(7):477-83.
The extent of osteogenic sarcoma has been measured in 30 bones obtained after local resection and compared with pre-operative evaluation. In only one case was the articular cartilage involved and the whole joint was resected. Other cases with a metaphyseal localisation were treated by disarticulation. Articular cartilage appears to provide good protection against local extension. In contrast, the growth cartilage, which was present in 11 cases, was crossed by tumour on three occasions. In only one case of diaphyseal localisation was a resection made across the tumour which had been previously rendered necrotic by chemotherapy. In most of the diaphyseal localisations, the post-operative study revealed that the resection had been over-extensive. Tomodensitometry is not very reliable in the precise evaluation of the extent of diaphyseal involvement.
对30例局部切除后获得的骨骼进行了骨肉瘤范围的测量,并与术前评估进行了比较。仅1例关节软骨受累,整个关节被切除。其他干骺端定位的病例采用关节离断术治疗。关节软骨似乎能有效防止肿瘤局部扩散。相比之下,11例存在生长软骨的病例中,有3例肿瘤穿过了生长软骨。仅1例骨干定位的病例在化疗使肿瘤坏死之后进行了肿瘤切除。在大多数骨干定位的病例中,术后研究显示切除范围过大。体层密度测定法在精确评估骨干受累范围方面不太可靠。