[The value of limb-saving surgery in the treatment of osteosarcoma]

Since 1981, 38 limb-saving operations for malignant bone tumors have been performed. Of these, 22 cases were osteosarcomas. The principle of limb-saving surgery for osteosarcoma is the same as for curative wide resection in cases of soft tissue sarcoma. Among the osteosarcoma cases for which limb-saving procedures were carried out, five complicated cases (two skip metastases and two infections) were noted. However, in the other cases, patients had better functional benefits and psychological acceptance compared with those subjected to radical ablative procedures. Indication for limb-saving surgery is usually decided by patient age, existence of skip metastasis and venous infiltration, effect of preoperative adjunctive therapy and the relationship of the tumor with the major artery necessary for preserving the affected limb. If the adjunctive therapy is effective, local control can be achieved by establishing a wide margin.