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Osteosarcoma in children: long-term functional analysis.

Per-Ulf Tunn1, Peter Schmidt-Peter, Doreen Pomraenke

  • 1Department of Surgery and Surgical Oncology, Robert Rössle Hospital and Tumor Institute, Max Delbrück Center for Molecular Medicine, Humboldt-University of Berlin Charité, Germany. tunn@rrk.charite-buch.de

Clinical Orthopaedics and Related Research
|May 5, 2004
PubMed
Summary
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Limb-saving therapy for pediatric osteosarcoma offers good long-term function, though endoprosthetic complications occur. Most survivors return to daily activities with minimal disability.

Area of Science:

  • Pediatric Oncology
  • Orthopedic Surgery
  • Rehabilitation Medicine

Background:

  • Multimodal, limb-saving therapy is standard for pediatric osteosarcoma.
  • Limited data exist on long-term functional outcomes and disabilities in survivors.

Purpose of the Study:

  • To evaluate long-term functional problems and disabilities in children treated for osteosarcoma.
  • To assess the effectiveness of limb-saving strategies and endoprosthetic use.

Main Methods:

  • Retrospective evaluation of 78 children with Stage II-B osteosarcoma (1970-1997).
  • Clinical examination, Musculoskeletal Tumor Society (MSTS) score, and Toronto Extremity Salvage Score (TESS) used for assessment.
  • Analysis of survival rates, limb-sparing procedures, and endoprosthesis complications.

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Main Results:

  • The most recent cohort (chemotherapy + resection) had a 70% 10-year survival rate.
  • 34 children (44%) underwent limb-sparing surgery; 25 required endoprostheses, with 40% needing replacements.
  • Subjective TESS scores indicated higher disability than objective MSTS scores.

Conclusions:

  • Limb-saving therapy is effective for pediatric osteosarcoma, enabling return to daily activities.
  • Endoprosthetic complications require monitoring and potential revision surgery.
  • Distal femur endoprostheses showed good functional outcomes, with up to 90% return to daily routines.