Intermediate results and functional evaluation of limb-salvage surgery for osteosarcoma: an intergroup study in Japan.
This is a 2-7-year follow-up report by 21 institutes in Japan concerning limb-salvage surgery for osteosarcoma. Between 1980 and 1985, 248 patients with osteosarcoma were treated, and 105 patients had limb-salvage surgery. The percentage of cases treated by limb-salvage surgery increased with each year. The cumulative survival rate was 71% at 5 years in the limb-salvage group, and in the amputation group it was 46%; this indicates that cases for limb-salvage patients, tumor resection was classified this procedure. In limb-salvage patients, tumor resection was classified according to the surgical margin as intralesional excision, marginal excision, wide-with-marginal resection, wide resection, and radical resection. Wide resection was performed in most cases as the method of choice. Local recurrence was seen in 13 cases (12%). The overall functional evaluations by Enneking's system showed that the number of results rated excellent or good was relatively high in the early follow-up period, but this decreased later on, and cases rated fair or poor increased as the years passed. This was mainly due to postsurgical complications (44 cases). We identify a few problems in the functional evaluation system used now and suggest a reform of the system, so that physical and mental factors would be evaluated separately.
Tomita
K
K
Department of Orthopedic Surgery, School of Medicine, Kanazawa University, Japan.
Tsuchiya
H
H
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D005121:Extremities / Q000601:surgery*; D005260:Female; D005266:Femoral Neoplasms / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D012516:Osteosarcoma / Q000401:mortality / Q000601:surgery*; D013997:Time Factors