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Intensive preoperative chemotherapy for osteosarcoma in the lower extremity
H Nakano1, A Tateishi, T Imamura
1Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Anticancer Research
|August 26, 1998
Summary
Preoperative chemotherapy and hyperthermic isolated regional perfusion (HIRP) improved limb salvage and function in osteosarcoma patients. These methods enabled reduced surgical margins, enhancing limb functionality and survival rates.
Area of Science:
- Orthopedic Oncology
- Surgical Oncology
- Neoadjuvant Chemotherapy
Background:
- Investigating the impact of preoperative chemotherapy on limb-salvaging procedures for osteosarcoma.
- Assessing the adaptability and limitations of limb-salvaging techniques to maximize limb functionality.
Observation:
- A study of 53 osteosarcoma cases (1983-1997) treated with neoadjuvant chemotherapy.
- Enneking surgical staging revealed 37 cases at stage II B and 16 at stage III.
- Specific protocol with hyperthermic isolated regional perfusion (HIRP) used for knee joint lesions.
Findings:
- Five-year survival rates were 68% for stage II B and 13% for stage III osteosarcoma.
- Chemotherapy protocols, including HIRP, effectively reduced surgical margins.
- Significant increase in limb-salvaging rates and improved salvaged limb functionality observed.
Implications:
- Preoperative chemotherapy and advanced perfusion techniques enhance limb preservation in osteosarcoma.
- Optimized surgical margins contribute to better functional outcomes.
- Limb-salvaging surgery combined with neoadjuvant chemotherapy offers improved limb functionality and survival rates.