Surgical Outcomes in Paediatric Lower Limb Sarcomas: A Single Institutional Experience

Area of Science:

• Orthopedic Oncology
• Pediatric Oncology
• Musculoskeletal Tumors

Background:

• Primary bone sarcomas are rare, particularly in children, posing significant challenges for limb salvage surgery due to growth considerations.
• Effective management requires balancing oncological control with optimal limb function in young patients.

Purpose of the Study:

• To assess the functional and oncological outcomes of limb salvage surgery in pediatric patients with malignant bone tumors of the lower limbs.
• To evaluate survival rates, recurrence rates, and functional scores in this patient cohort.

Main Methods:

• An observational retrospective study of 52 pediatric patients (Jan 2011-Dec 2018) with lower limb malignant bone tumors.
• Postoperative functional outcomes assessed via questionnaires and clinico-radiological examination.
• Analysis included survival rates, metastasis status, surgical techniques (biological, prosthesis, amputation), and Musculoskeletal Tumor Society (MSTS) scores.

Main Results:

• Osteosarcoma (85%) and Ewing sarcoma (15%) were the main diagnoses; mean age was 12.88 years.
• Three-year overall survival rate was 61.73%. Patients without metastasis had significantly longer survival.
• Mean MSTS score was 80.1%, with a local recurrence rate of 3.85% and a recurrence-free rate of 96.15%.

Conclusions:

• Limb salvage surgery in pediatric bone sarcoma patients yields excellent functional and oncological outcomes, comparable to global literature.
• Complete surgical resection is crucial for achieving cure.
• Surgical approach (biological, prosthesis, amputation) did not significantly impact overall survival in this study.