骨肉瘤患者的保留患肢治疗60例报告

Limb-salvage surgery in 60 patieuts with osteosarcoma

１９７４年１月～１９９３年１２月，作者共收治骨肉瘤患者１０４例，其中６０例行保留患肢治疗。术式采用肿瘤大块切除，其中行人工关节置换者５４例，血管吻合自体腓骨移植者３例，肿瘤局部切除者３例。施行大剂量综合化疗４８例，其中ⅡＢ期骨肉瘤４４例，５年生存率为４４．６９％。总的局部发生率为１５％，感染率为１２．９％，人工关节机械合并症为１４．８％，人工关节功能良好率为６４．８１％。今后努力的方向是提高生存率，降低局部复发率，改进人工关节。

AbstractLimb-salvage surgery plays an important role inthe treatment of osteosarcoma. From 1974 to 1993,104 patients with osteosarcoma were treated in ourdepartment.Sixty of them were treated with limb-sal-vage procedures. In fourty-four patients of stage Ⅱ Breceiving adjuvant chemotherapy,the five-year sur-vival rate was 46.69%,The overall local recurrencerate was 15%. The infection rate was 12.9%,and me-chanical complication occurred in 14.8%of the pa-tients. The functional result was generally good.Im-proved concepts of en bloc resection and better recon-structive techniques suggest that limb-salvage pro-cedures are not only possible but can provide excellentfunctional result in patients with osteosarcoma. Fur-ther work must be directed to reducing local recurrenceand improving reconstructive techniques.