The Clinical Analysis Of The Limb Osteosarcoma With Limb-salvage Surgery

Objective:To explore the clinical efficacy of limb osteosarcoma with limb-salvage surgery.Method:The clinical datas of44limb osteosarcoma patients diagnosed by the pathologic biopsy were retrospective analysis between May2005and May2011. The patients included24males and20females, whose ages were from10to51, with the average of18.7. According to surgery, they were divided into two groups:neoplasm inactivate group (n=26) and prosthesis replacement group (n=18). Two groups were compared with the survival rate, the recurrence rate and the functional evaluation of reconstructive procedures.Results:During a follow-up form7months to73months and an average of31.6months,16patients had been dead and6had been lost to follow-up. Survive:3-year overall survival rate of neoplasm inactivate group is60.1%, while that of prosthesis replacement group is70%. On the base of the neoadjuvant chemotherapy,3-year overall survival rate of neoplasm inactivate group had the similar survival rate with that of prosthesis replacement group, so there is no statistically significant (P>0.05). Recurrence:the recurrence of neoplasm inactivate group is15.4%, while that of prosthesis replacement group is5.6%. The recurrence of neoplasm inactivate group had the similar recurrenct rate with that of prosthesis replacement group without statistically significant (P>0.05). Functional evaluation:the prosthesis replacement group was26.4points in six months after surgery, while the neoplasm inactivate group was an average of22.9points. Through T test, the prosthesis replacement group had the higher fineness rate than the neoplasm inactivate group, so there is statistically significant (P<0.001).Conclusions:New adjuvant chemotherapy can control and kill the metastatic cell of osteosarcoma and eliminate tiny metastatic lesions. On the base of the neoadjuvant chemotherapy, two limb-salvage surgeries have no obvious differences in the survival rate and local recurrence rate. Combined with the functional evaluation of reconstructive procedure, the patient with limb osteosarcoma had the highest fineness in prosthesis replacement. Once the osteosarcoma is diagnosed, the preoperative chemotherapy is carried out as soon as possible. So neoadjuvant chemotherapy combined with the prosthesis replacement is an ideal treatment of the limb osteosarcoma.