Rajan Sreeraj, Hindiskere Suraj, Chinder Pramod S
Department of Orthopaedic Oncology, Aster MIMS Hospital, Calicut, Kerala 673016 India.
Department of Musculoskeletal Oncology, HCG Hospital, Bangalore, India.
Indian J Surg Oncol. 2024 Mar;15(Suppl 1):106-111. doi: 10.1007/s13193-023-01755-3. Epub 2023 May 26.
Primary bone sarcomas are rare tumours, comprising approximately 1-2% of adult and around 13-15% of all paediatric cancers. Limb salvage surgery is a challenge in complex musculoskeletal tumours. Young age adds to its complexity, since the growth potential of the reconstruct has to be considered to have optimal function of the salvaged limb. An observational retrospective study performed on 52 paediatric patients between Jan 2011 and Dec 2018 with malignant bone tumour of lower limbs had been assessed for postoperative functional outcomes with questionnaires and clinico-radiological examination for functional and oncological outcome. Out of 52 patients, 44 (85%) were diagnosed with osteosarcoma and the rest (15%) were diagnosed with Ewing sarcoma. Mean age was 12.88 years. Three-year overall survival rate was found to be 61.73%. Fifteen patients (28%) had metastasis at the time of presentation; non-metastasis patients (56.33 months) had a higher mean survival time, as compared to metastasis patient (29.06 months). Overall survival in group of patients undergoing biological, prosthesis and amputation surgeries were found to be similar. Mean MSTS score at final follow-up was 24.05 (80.1%), and in our study, 3.85% (2 out of 52) had local recurrence, and local recurrence free rate was found to be 96.15% (50 out of 52). The present study had excellent functional and oncological outcome at final follow-up which is comparable to the world literature. Complete surgical resection, if feasible, remains essential for cure.
原发性骨肉瘤是罕见肿瘤,约占成人癌症的1 - 2%,在所有儿童癌症中约占13 - 15%。保肢手术对于复杂的肌肉骨骼肿瘤来说是一项挑战。患者年龄小会增加其复杂性,因为必须考虑重建物的生长潜力,以使保肢后的肢体功能达到最佳。对2011年1月至2018年12月期间52例患有下肢恶性骨肿瘤的儿科患者进行了一项观察性回顾性研究,通过问卷调查以及功能和肿瘤学结果的临床放射学检查来评估术后功能结局。52例患者中,44例(85%)被诊断为骨肉瘤,其余(15%)被诊断为尤因肉瘤。平均年龄为12.88岁。三年总生存率为61.73%。15例患者(28%)在就诊时已有转移;无转移患者的平均生存时间(56.33个月)高于有转移患者(29.06个月)。接受生物治疗、假体植入和截肢手术的患者组的总生存率相似。最后一次随访时的平均肌肉骨骼肿瘤学会(MSTS)评分为24.05(80.1%),在我们的研究中,3.85%(52例中有2例)出现局部复发,局部无复发生存率为96.15%(52例中有50例)。本研究在最后一次随访时具有良好的功能和肿瘤学结局,与世界文献报道相当。如果可行,完整的手术切除对于治愈仍然至关重要。