Advances in bone tumour treatment in 30 years with respect to survival and limb salvage. A single institution experience.
We analysed 721 patients with primary malignant bone tumours treated in a single institution with regard to diagnosis, treatment and prognosis. From 1965 to 1974, 154 patients were treated, of whom 17% had no surgery, 36% underwent resection and 46% underwent amputation. Margins of resection were intralesional in 21%, 72% of patients received chemotherapy and overall survival rate was 24%. From 1975 to 1984, 174 patients were treated, of whom 12% had no surgery, 54% underwent limb salvage procedures and 34% underwent amputation or resection-replantation. Margins of resection were intralesional in 16% 67% of patients received chemotherapy and overall survival rate was 46%. From 1985 to 1994, 393 patients were treated, of whom 7% had no surgery, 77% underwent limb salvage procedures - mainly with endoprostheses - and 15% underwent amputation or resection-replantation. Margins of resection were intralesional in 12%, 68% of patients received chemotherapy and overall survival rate was 62%. Advancements in the treatment of primary malignant bone tumours justify limb salvage procedures in combination with highly effective polychemotherapy in specialised centres and has resulted in an overall survival rate of more than 60%.
Department of Orthopaedics, Medical Faculty, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. rainer.kotz@akh-wien.ac.at
Rainer
R
Kotz
Martin
M
Dominkus
Teresa
T
Zettl
Peter
P
Ritschl
Reinhard
R
Windhager
Helmut
H
Gadner
Christoph
C
Zielinski
Mechthild
M
Salzer-Kuntschik
D000671:Amputation, Surgical; D001317:Austria / Q000453:epidemiology; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D023821:Limb Salvage; D012516:Osteosarcoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D012042:Registries; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D016896:Treatment Outcome