Intensive preoperative chemotherapy for osteosarcoma in the lower extremity.

BACKGROUND

The aims of this study were to investigate the effect, if any, of preoperative chemotherapy and to investigate the adaptation and the limits for achieving a more functional limb in our limb-salvaging procedure.

MATERIALS AND METHODS

Since 1983 to 1997 we have treated 53 cases of osteosarcoma in an upper or lower limb at our Institute. According to surgical staging by Enneking, there were 37 cases at stage II B, and 16 cases at stage III. Neoadjuvant chemotherapy was performed according to one or other of our four protocols.

RESULTS

The 5-year-survival rate was 68% for those cases at stage II B, and was 13% for those at stage III. In particular, we adopted the protocol involving hyperthermic isolated regional perfusion (HIRP) for those cases in which the lesion affected the knee joint.

CONCLUSION

The various protocols of chemotherapy including HIRP were effective to permit reduction in the surgical margin and were also effective to achieve an increase in the limb-salvaging rate and especially effective for increasing the salvaged limb-functionality.