Long-term local intensive preoperative chemotherapy and joint-preserving conservative surgery for osteosarcoma around the knee.
This study evaluated conservative joint-sparing surgery for patients with osteosarcoma around the knee. Of 23 patients with stage IIB osteosarcoma around the knee, 5 were treated with long-term (30-56 weeks) local intensive preoperative chemotherapy consisting of high-dose methotrexate, intra-arterial and intravenous cisplatinum, doxorubicin, and hyperthermic isolated regional perfusion. More conservative resection, sparing the knee joint, was performed with smaller sufficient surgical margin in these 5 patients, preserving good limb function. Excellent local effects were achieved in the resected specimens. These results suggest long-term local intensive preoperative chemotherapy, including intra-arterial cisplatin and hyperthermic isolated regional perfusion, help control local tumor and allow for more conservative surgery.
Abe
S
S
Department of Orthopedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Tateishi
A
A
Ogawa
K
K
Ganev
G G
GG
Nakano
H
H
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant / Q000379:methods / Q000592:standards; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods* / Q000592:standards; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005266:Femoral Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods* / Q000592:standards; D007262:Infusions, Intravenous; D007269:Injections, Intra-Arterial; D007719:Knee Joint; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011300:Preoperative Care / Q000379:methods* / Q000592:standards; D013977:Tibia; D013997:Time Factors; D016896:Treatment Outcome
D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate