Limb-salvage operations in primary malignant tumors of the bone--interim report

Between June 1985 and March 1990, 25 patients with primary malignant bone tumors, including 15 cases of osteogenic sarcoma, two cases of periosteal osteogenic sarcoma, six cases of chondrosarcoma, and two cases of malignant fibrous histiocytoma, were treated with limb-salvage procedures. Fourteen patients underwent limb salvage operations with tumor prosthesis arthroplasty, 6 with resection-arthrodesis, 4 with wide resection, and 1 with autoclaved autograft. Pre- and/or post-operative chemotherapy with or without radiotherapy was combined with these limb salvage operations. The average follow-up period was 25.2 months (6 to 52 months) since diagnosis. The estimated 3.5-year survival rate of the total 25 patients was 39.5% based on the Kaplan-Meier survival plot. In the 15 cases of osteogenic sarcoma, the estimated Kaplan-Meier 34-month survival rate was 46.2%. Seventeen patients who were followed up for more than 1 year were grouped by functional grading: 11 (65%) were excellent; 3 (18%) good; 2 fair (12%); and 1 poor. Complications occurred in 4 patients, 1 had a local recurrence, 2 had superficial wound infections, and 1 a loosening of the femoral stem. Metastases were shown in 15 case, and the most common location was the lung.