骨肉瘤保肢重建术式与患者预后

Reconstruction Surgery of Osteosarcoma and Prognosis of Patients

目的 :评价骨肉瘤保肢手术重建方法与患者的远期预后的关系。方法 :回顾性研究 1985～ 1999年 50例行保肢手术的IIB期肢体骨肉瘤患者。重建方法 :灭活再植 2 5例 ,肿瘤型人工假体置换 12例 ,异体半关节置换 9例 ,带血管腓骨移植 4例。统计学分析不同重建方法与患者远期预后的关系。结果 :保肢手术中非瘤段保留组患者较瘤段保留组患者局部复发率低 ,远期生存率高 ;有统计学差异。结论 :骨肉瘤保肢术应首选人工关节置换。

Objective: To evaluate the relation between various reconstruction surgeries in primary osteosarcoma cases and prognosis of patients. Methods: Between 1985 and 1999, 50 patients aging from 11 to 55 years with the diagnosis of II B extremity osteosarcoma, were treated with definitive surgery and adjuvant chemotherapy regimens, which included devitalized tumor bone reimplantation in 25 cases, endoprosthestic replacement in 12 cases, osteoarticular allograft implantation in 9 cases, and vascularized fibula autograft implantation in 4 cases. Result: The long-term prognosis of patients in tumor bone reservation group was worse than those in tumor bone non-reservation group. Conclusion: Endoprosthestic replacement is the best choice of limb salvage surgery in osteosarcoma cases.