Osteosarcoma of the limb. Amputation or limb salvage in patients treated by neoadjuvant chemotherapy.
作者： M. Mercuri , G. Bacci , A. Longhi , D. Donati , M. Versari
DOI: 10.1302/0301-620X.84B1.12211
关键词: Upper limb 、 Amputation 、 Rotationplasty 、 Proportional hazards model 、 Surgery 、 Survival analysis 、 Osteosarcoma 、 Orthopedic surgery 、 Chemotherapy 、 Medicine
摘要: We have studied 560 patients with osteosarcoma of a limb, who had been treated by neoadjuvant chemotherapy, in order to analyse the incidence local and systemic recurrence according type surgery undertaken. Of these, 465 limb-salvage procedure 95 amputation or rotationplasty. At median follow-up 10.5 years there 225 recurrences. The five-year disease-free survival overall rates were 60.7% 68.5%, respectively, no significant difference between undergoing those resection. was same for either limb salvage correlated significantly margins surgical excision histological response chemotherapy. outcome worse than recurrent disease metastases only. conclude that procedures are relatively safe They should, however, only be performed institutions where chemotherapy can accurately assessed. If inadequate is poor an immediate should considered.
elsevier.com
boneandjoint.org.uk 
sci-hub.se 参考文章(17)
Stefano Ferrari, Mario Mercuri, Piero Picci, Franco Bertoni, Adalberto Brach Del Prever, Amelia Tienghi, Antonia Mancini, Alessandra Longhi, Simonetta Rimondini, Davide Donati, Marco Manfrini, Pietro Ruggieri, Roberto Biagini, Gaetano Bacci, Nonmetastatic osteosarcoma of the extremity: results of a neoadjuvant chemotherapy protocol (IOR/OS-3) with high-dose methotrexate, intraarterial or intravenous cisplatin, doxorubicin, and salvage chemotherapy based on histologic tumor response. Tumori. ,vol. 85, pp. 458- 464 ,(1999) , 10.1177/030089169908500607
G. Bacci, P. Picci, P. Ruggieri, M. Mercuri, M. Avella, R. Capanna, A. Brach Del Prever, A. Mancini, F. Gherlinzoni, G. Padovani, C. Leonessa, R. Biagini, A. Ferraro, A. Ferruzzi, A. Cazzola, M. Manfrini, M. Campanacci, Primary chemotherapy and delayed surgery (neoadjuvant chemotherapy) for osteosarcoma of the extremities the istituto rizzoli experience in 127 patients treated preoperatively with intravenous methotrexate (high versus moderate doses) and intraarterial cisplatin Cancer. ,vol. 65, pp. 2539- 2553 ,(1990) , 10.1002/1097-0142(19900601)65:11<2539::AID-CNCR2820651125>3.0.CO;2-M
Piero Picci, Gaetano Bacci, Mario Campanacci, Marco Gasparini, Silvana Pilotti, Serenella Cerasoli, Franco Bertoni, Aristide Guerra, Rodolfo Capanna, Ugo Albisinni, Stefano Galletti, Franco Gherlinzoni, Pierina Calderoni, Alessandra Sudanese, Nicola Baldini, Marzia Bernini, Norman Jaffe, Histologic evaluation of necrosis in osteosarcoma induced by chemotherapy regional mapping of viable and nonviable tumor Cancer. ,vol. 56, pp. 1515- 1521 ,(1985) , 10.1002/1097-0142(19851001)56:7<1515::AID-CNCR2820560707>3.0.CO;2-6
KURT WINKLER, PATRICIA BIELING, STEFAN BIELACK, GUNTER DELLING, CRISTHILD DOSE, HERBERT JURGENS, RAINER KOTZ, JURG RITTER, MECHTHILD SALZER-KUNTSCHIK, Local control and survival from the Cooperative Osteosarcoma Study Group studies of the German Society of Pediatric Oncology and the Vienna Bone Tumor Registry. Clinical Orthopaedics and Related Research. pp. 79- 86 ,(1991) , 10.1097/00003086-199109000-00013
M. Sluga, R. Windhager, S. Lang, H. Heinzl, S. Bielack, R. Kotz, Local and systemic control after ablative and limb sparing surgery in patients with osteosarcoma. Clinical Orthopaedics and Related Research. ,vol. 358, pp. 120- 127 ,(1999) , 10.1097/00003086-199901000-00015
Norbert J. Lindner, Oliver Ramm, Axel Hillmann, Robert Roedl, Georg Gosheger, Christian Brinkschmidt, Heribert Juergens, Winfried Winkelmann, Limb salvage and outcome of osteosarcoma. The University of Muenster experience. Clinical Orthopaedics and Related Research. ,vol. 358, pp. 83- 89 ,(1999) , 10.1097/00003086-199901000-00011
W F Enneking, A Kagan, The implications of "skip" metastases in osteosarcoma. Clinical Orthopaedics and Related Research. ,vol. 111, pp. 33- 41 ,(1975) , 10.1097/00003086-197509000-00005
Gaetano Bacci, Stefano Ferrari, Mario Mercuri, Franco Bertoni, Piero Picci, Marco Manfrini, Alessandro Gasbarrini, Cristiana Forni, Marilena Cesari, Mario Campanacci, Predictive factors for local recurrence in osteosarcoma 540 patients with extremity tumors followed for minimum 2.5 years after neoadjuvant chemotherapy Acta Orthopaedica Scandinavica. ,vol. 69, pp. 230- 236 ,(1998) , 10.3109/17453679809000921
Gaetano Bacci, Piero Picci, Stefano Ferrari, Pietro Ruggieri, Roberto Casadei, Amelia Tienghi, Alberto Brach Del Prever, Franco Gherlinzoni, Mario Mercuri, Carlo Monti, Primary chemotherapy and delayed surgery for nonmetastatic osteosarcoma of the extremities. Results in 164 patients preoperatively treated with high doses of methotrexate followed by cisplatin and doxorubicin Cancer. ,vol. 72, pp. 3227- 3238 ,(1993) , 10.1002/1097-0142(19931201)72:11<3227::AID-CNCR2820721116>3.0.CO;2-C
William F. Enneking, Suzanne S. Spanier, Mark A. Goodman, A system for the surgical staging of musculoskeletal sarcoma. Clinical Orthopaedics and Related Research. ,vol. 153, pp. 4- 18 ,(1980) , 10.1097/01.BLO.0000093891.12372.0F