| Objective: To evaluate the clinical outcome of 46 patients who were treated by Co60 devitalized tumor bone reimplantation and amputation.To analysis the difference of the two kind surgery's survival rate and discuss the related problems.Methods: We treated 46 patients suffered osteosarcoma from 1996 to 2005 . There were 24 males and 22 females.The age was 11～42 and the mean age was 15.3 years. The tumor sites were distant femur (25), proximal and middle place of femur (10), proximal tibia (8), middle place of tibia(2),proximal fibular(1),all case histologic diagnoses were osteosarcoma.The stage of tumor was II b in 7patients, II a in 34, and I b in 5.All the patients received chemotherapy of postoperative at least.Among all case,21 patients received bone tumor resection and Co60 devitalized tumor bone reimplantation, and 25 patients underwent amputation. Postoperative chemotherapy were performed in all patients.Results: 42 of all patients were followed up for 6 to 75 months. In limb-salvage surgery group ,the proportion of patients with 3-year overall survival was 42.9% and with 5-year overall survival was 28.6%. In amputation group,the proportion of patients survival was 48.0% and with 5-year overall survival was 36.0%. There was no significant difference between the two groups in the survival rate by log-rank test .(P>0.05 ,means no significant difference). After surgical treatment,we carried on the functional evaluation of procedures according to standard of ISOLS. The functional evaluation of limb-salvage treatment after surgical treatment was satisfactory in short-term,but the forward effect was bad.Conclusion: Limb-salvag of Co60 devitalized tumor bone reimplantation and amputation surgery would lead to a similar survival outcome, limb-salvage surgery could retain the function of reconstructive extremity after bone tumor resection for osteosarcoma.To sum up,the clinical outcome of limb-salvage is superior to amputation treatment.
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