Comparison Of Extracorporeal Irradiated Autograft And Alcohol-inactivated Autograft For The Treatment Of Lower-limb Osteosarcoma

ObjectiveThrough clinical observation and research,to compare the operation time,the intraoperative blood loss,healing time of the fracture,the MSTS scores,postoperative complications,disease recurrence and lung metastasis between extracorporeal irradiated autograft and alcohol-inactivated autograft for the treatment of lower-limb osteosarcoma,and provide a reference for clinicians.Materials and MethodsRetrospective analysis clinical data of 22 cases who underwent extracorporeal irradiated autograft or alcohol-inactivated autograft for the treatment of lower-limb osteosarcoma from June 2014 to January 2017 in the Department of Bone and Soft Tissue of the Affiliated Cancer Hospital of Zhengzhou University.10 Patients(6 males and 4 females)in Group A who were treated with extracorporeal irradiated autograft.12 patients(8 males and 4 females)in Group B who were treated with alcohol-inactivated autograft.The operation time,the intraoperative blood loss,healing time of the fracture,the MSTS scores,postoperative complications,disease recurrence and lung metastasis were compared between the two groups,and statistical evaluation was performed.Results1.Operation time The operation was performed by the same chief physician.The operation time of group A was 390~434 min,with an average of(413.70±17.74)min.The operation time of group B was 325~418 min,with an average of(374.58±24.47)min.The difference between the two groups was statistically significant.(P < 0.001)2.Intraoperative blood loss According to the surgical record data written by the chief physician,the intraoperative blood loss of group A was 380~600 ml,with an average of(474.00±66.70)ml.The intraoperative blood loss of group B was 320~450 ml,with an average of(378.33±40.86)ml.The difference between the two groups was statistically significant.(P < 0.001)3.Healing time of the fracture The healing time of fractures in group A was 32~48 weeks,with an average of(36.89±5.21)weeks.The healing time of fractures in group B was 32~92 weeks,with an average of(60.00±18.87)weeks.The difference between the two groups was statistically significant.(P = 0.006)4.The MSTS scores The MSTS score of group A was 23~28 points,with an average of(25.70±1.80)points;the MSTS score of group B was 22~26 points,with an average of(24.00±1.32)points.The difference between the two groups was statistically significant.(P = 0.04)5.Postoperative complications,disease recurrence and lung metastasis The incidence of postoperative surgical incision soft tissue infection,plate fracture,local recurrence and lung metastasis in group A was 0.00%,10.00%,0.00%,10.00%,respectively.The incidence of postoperative surgical incision soft tissue infection,plate fracture,local recurrence and lung metastasis in group B were 16.67%,16.67%,16.67%,and 16.67%,respectively.The difference between the two groups was not statistically significant.(P = 0.48?1?0.481?1)ConclusionsExtracorporeal irradiated autograft and alcohol-inactivated autograft are the primary options for patients with lower-limb osteosarcoma who can be treated with autograft reconstruction.This retrospective study shows that alcohol-inactivated autograft has obvious advantages in shortening operation time and reducing intraoperative blood,and the operation is relatively simple.Extracorporeal irradiated autograft with the advantage of short fracture healing time and good Lower-limb function.