Tian Zhichao, Dong Shuping, Yang Yang, Qu Guoxin, Liu Guancong, Liu Xu, Ma Yue, Wang Xin, Yao Weitao
Department of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China.
Modern Educational Technology Center, Henan University of Economics and Law, Zhengzhou, Henan, China.
Front Oncol. 2024 Feb 23;14:1278237. doi: 10.3389/fonc.2024.1278237. eCollection 2024.
The frozen inactivation of autologous tumor bones using liquid nitrogen is an important surgical method for limb salvage in patients with sarcoma. At present, there are few research reports related to frozen inactivated autograft replantation.
In this study, we retrospectively collected the clinical data of patients with bone and soft tissue sarcoma treated with liquid nitrogen-frozen inactivated tumor bone replantation, and analyzed the safety and efficacy of this surgical method. The healing status of the frozen inactivated autografts was evaluated using the International Society of Limb Salvage (ISOLS) scoring system. Functional status of patients was assessed using the Musculoskeletal Tumor Society (MSTS) scale.
This study included 43 patients. The average length of the bone defect after tumor resection is 16.9 cm (range 6.3-35.3 cm). Patients with autograft not including the knee joint surface had significantly better healing outcomes (ISOLS scores) (80.6% ± 15% 28.2% ± 4.9%, P<0.001) and limb function (MSTS score) (87% ± 11.6% 27.2% ± 4.4%, P<0.001) than patients with autografts including the knee joint surface. The healing time of the end of inactivated autografts near the metaphyseal was significantly shorter than that of the end far away from the metaphyseal (9.8 ± 6.3 months 14.9 ± 6.3 months, P=0.0149). One patient had local recurrence, one had an autograft infection, five (all of whom had an autograft including the knee joint surface) had joint deformities, and seven had bone non-union.
Frozen inactivated autologous tumor bone replantation is safe and results in good bone healing. But this method is not suitable for patients with autograft involving the knee joint surface.
使用液氮对自体肿瘤骨进行冷冻灭活是肉瘤患者保肢手术的一种重要方法。目前，关于冷冻灭活自体骨移植再植的研究报道较少。
本研究回顾性收集了接受液氮冷冻灭活肿瘤骨再植治疗的骨与软组织肉瘤患者的临床资料，分析该手术方法的安全性和有效性。采用国际保肢协会（ISOLS）评分系统评估冷冻灭活自体骨的愈合情况。使用肌肉骨骼肿瘤学会（MSTS）量表评估患者的功能状态。
本研究纳入43例患者。肿瘤切除后骨缺损的平均长度为16.9 cm（范围6.3 - 35.3 cm）。自体骨未包括膝关节面的患者，其愈合结果（ISOLS评分）（80.6% ± 15% 对28.2% ± 4.9%，P<0.001）和肢体功能（MSTS评分）（87% ± 11.6% 对27.2% ± 4.4%，P<0.001）明显优于自体骨包括膝关节面的患者。灭活自体骨靠近干骺端的一端愈合时间明显短于远离干骺端的一端（9.8 ± 6.3个月对14.9 ± 6.3个月，P = 0.0149）。1例患者出现局部复发，1例发生自体骨感染，5例（均为自体骨包括膝关节面者）出现关节畸形，7例出现骨不连。
冷冻灭活自体肿瘤骨再植是安全的，且能实现良好的骨愈合。但该方法不适用于自体骨涉及膝关节面的患者。
