Overall Results and Functional Evaluation of Limb Salvage for Osteosarcoma

Abstract

A report is presented of the Intergroup Study of Osteosarcoma by 22 university hospitals and cancer centers in Japan with an assessment and proposal for reorganization of the functional evaluation system. Between 1980 and 1985, 248 patients with osteosarcoma were treated and 105 patients (42.3%) underwent limb salvage surgery. For these cases, functional evaluation was studied in July 1987. The follow-up period was 2–7 years. The cumulative survival rate was 71.0% at 5 years in the limb salvage group, while in the amputation group it was 45.7%. The results of overall functional evaluation of the preserved limbs according to the standard system is that the number of cases rating excellent or good was relatively high in the 2- to 4-year follow-up period; however, this later decreased. Cases rating fair or poor increased after 4 years. Based on our data, we clarified a few problems in the present functional evaluation system and revised it; we separated physical function (factors 1–6) and mental evaluation (factor 7). We also put a higher value on factor 6 to attach importance to the whole preserved limb function. We believe that salvaged limbs are much more objectively evaluated by our new revised system.