Surgical options and outcomes in bone sarcoma.

Expert Rev Anticancer Ther. 2006 Feb;6(2):239-48.  

Surgical options and outcomes in bone sarcoma.

Wafa H, Grimer RJ.

The Royal Orthopaedic Hospital NHS Trust, Bristol Road South,
Northfield, Birmingham, B31 2AP, UK.

Bone sarcomas are challenging to treat. The primary goal of treatment
is local control of the disease while, if possible, achieving salvage
of the limb and its function. There is no ideal method of
reconstruction in limb-salvage surgery but the choice of the method of
reconstruction should be individualized based upon many factors
including the patient's age, the extent and location of the tumor, the
wishes of the patient, and the availability of surgical facilities and
expertise, as well as the cost of the procedure. In this review, the
authors explore the advantages and disadvantages of the different
methods of limb reconstruction. The surgical management of bone
sarcomas is a real challenge to the orthopedic surgeon, owing to the
diversity of sites in which tumors arise, combined with the extension
of the tumor into adjacent soft tissues and their proximity, in many
cases, to major neurovascular structures. There have been dramatic
improvements in survival for patients with osteosarcoma and Ewing's
sarcoma in the past 30 years owing to increasing effectiveness of
chemotherapy. This, along with developments in imaging techniques
(magnetic resonance imaging in particular) has led to earlier diagnosis
and more accurate preoperative staging. Whilst traditional treatment
for bone tumors used to be amputation, advances in surgical techniques
have made limb-salvage procedures a valid alternative method of
treatment to amputation in 80-85% of patients with primary bone

PMID: 16445376 [PubMed – in process]

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