Limb salvage surgery for osteosarcoma: effective low-cost treatment

Area of Science:

• Orthopedic Oncology
• Surgical Innovation
• Global Health

Background:

• Osteosarcoma management in developing nations presents significant challenges.
• Limb salvage surgery offers a potential alternative to amputation.

Purpose of the Study:

• To evaluate the early outcomes of a cost-effective limb salvage surgery protocol for high-grade osteosarcoma.
• To assess the feasibility of using custom-designed megaprostheses in resource-limited settings.

Main Methods:

• Prospective data collection of 135 high-grade osteosarcoma patients treated between 2000-2004.
• Neoadjuvant chemotherapy (excluding methotrexate) followed by limb salvage surgery.
• Use of custom-fabricated stainless steel megaprostheses in 78 patients.

Main Results:

• Follow-up data available for 120 patients (24-72 months).
• 61% of patients were disease-free at follow-up.
• Functional scores averaged 85% for lower extremity and 66% for shoulder reconstructions.

Conclusions:

• Osteosarcoma can be effectively managed in developing countries using a cost-effective limb salvage approach.
• Limb salvage surgery, combined with tailored chemotherapy, is a viable and increasingly standard treatment option.
• Custom megaprostheses demonstrate acceptable outcomes despite challenges in resource-limited environments.