31例骨肉瘤保肢治疗的中长期疗效观察

目的评价保肢手术结合新辅助化疗治疗肢体骨肉瘤的临床疗效。方法选择1995年1月至2003年1月新辅助化疗结合保肢手术治疗的骨肉瘤31例。达到广泛切除22例,仅达边缘切除9例。所有病例切除标本均做多病理切片的坏死率评估。随访2~8年。结果31例中无瘤生存超过5年者19例(61.3%),肿瘤局部复发4例(12.9%)。肢体功能评估优良率为67.7%。结论新辅助化疗结合保肢手术是治疗肢体骨肉瘤理想的治疗方法,术前有效化疗是保肢术成功的关键。

Observation on medium to long term curative effect of limb salvage in treating 31 cases of osteosarcoma

Objecttive To evaluate the clinical effectiveness of limb salvage surgery combined with new adjuvant chemotherapy for extremity osteosarcoma.Methods From January 1995 to January 2003,31 patients with the diagnosis of extremity osteosarcoma were treated with combined new adjuvant chemotherapy and limb salvage surgery.The histological evaluation of surgical margins revealed wide resection in 22 patients and marginal resection in 9 patients.Multiple histological sections were examined from each of the resected specimens to determine the effect of the chemotherapeutic agents.All patients were followed from 2 to 8 years.Results Among 31 cases,19(61.3%)belonged to disease-free survival at 5 years,4(12.9%) had local recurrence.The evaluated functional result revealed an excellent or good result in 67.7% of the patients.Conclusion The new adjuvant chemotherapy combined with limb salvage surgery is an ideal treatment method for the extremity osteosarcoma.An effective preoperative chemotherapy make limb salvage surgery successful.