Eckardt J J, Eilber F R, Dorey F J, Mirra J M
Orthopedics. 1985 May;8(5):612-21. doi: 10.3928/0147-7447-19850501-15.
Between December 1980 and January 1985, 95 patients with 98 malignant bone tumors were treated at UCLA by a multidisciplinary approach. Seventy-eight patients with 81 lesions underwent primary limb salvage procedures utilizing 66 custom endoprostheses and, in 15 instances, soft tissue reconstruction alone. Sixty-three of 78 (80.7%) underwent successful limb salvage without complication. The 22 local complications in 15 patients (19.2%) were all successfully managed either by surgical or nonoperative techniques salvaging all 15 extremities at risk. Seventeen patients underwent primary amputation for local control of their tumor. The local recurrence rate of 6.4% in the limb salvage group is comparable to the 5.8% found in the amputation group. The selection of patients for limb salvage did not adversely prejudice these patients in terms of rates of progression or ultimate survivorship. The cosmetic and functional results of limb sparing surgery is felt to be at least comparable with that obtained by primary amputation and the use of external prostheses.
1980年12月至1985年1月期间，加州大学洛杉矶分校采用多学科方法治疗了95例患有98处恶性骨肿瘤的患者。78例有81处病灶的患者接受了保肢手术，其中66例使用了定制的内置假体，15例仅进行了软组织重建。78例患者中有63例（80.7%）成功保肢且无并发症。15例患者出现22处局部并发症（19.2%），均通过手术或非手术技术成功处理，保住了所有15个有风险的肢体。17例患者接受了原发灶截肢以控制肿瘤。保肢组6.4%的局部复发率与截肢组5.8%的复发率相当。选择保肢治疗的患者在疾病进展率或最终生存率方面并未受到不利影响。保肢手术的美容和功能效果被认为至少与原发灶截肢及使用外部假体相当。
