骨原発性悪性腫ように対する患肢温存手術とその機能的予後の検討

Abstract

Limb-salvage operations in the treatment of malignant bone tumors were analyzed with particular attention given to functional results.This atudy evaluates twelve patients (8 males, 4 females). The location of the primary tumor was the humerus in 3 patients, femur in seven and tibia in three. Histological diagnosis included conventional osteosarcoma in 7, chondrosarcoma in 3 and malignant fibrous histiocytom (MFH) in 2. Using Enneking's criteria surgical stage was evaluated as I A in one, I B 4 and II B in 7. Curative wide excision or wide excision was applied in all cases.At an average thirty six-month follow-up, no patients showed any evidence of local recurrence and complication. However, four patients had lung metastases, three of them dying from this diseaes. Postoperative function was analyzed according to Enneking's functional criteria. The over-all rating was good in one and fair in 2 for the upper extremity; excellent in 2, good in 6 and fair in one for the lower extremity. Good results in ADL were obtained in both the upper and lower extremity except for arthrodesis of the knee joint.Limb-salvage operation in malignant bone tumor is justified from both an oncological and a functional standpoint.