title: Limb salvage surgery complimented by customised mega prostheses for malignant fibrous histiocytomas of bone.
abstract: OBJECTIVE
  To assess functional and oncological outcomes of patients with malignant fibrous histiocytomas of bone, after limb salvage surgery complimented by a customised prosthesis.
  
  
  METHODS
  Between May 1991 and December 2002, 15 men and 5 women (mean age, 42 years) with histologically proven malignant fibrous histiocytoma of bone underwent treatment involving limb salvage surgery complimented by a customised mega prosthesis. Most of the tumours were stage II according to the Enneking system, and located around the knee. Wide resection margins were achieved in 18 patients.
  
  
  RESULTS
  Following a mean follow-up of 58 months, 4 patients underwent amputation for local recurrence and 5 died of the disease. Two patients had prosthesis fractures; revision of the prosthesis was carried out in one. The functional result was excellent in 5 and good in 9 patients. The Kaplan-Meier 5-year survival rates of the patients treated without chemotherapy and with chemotherapy were 50% and 76%, respectively.
  
  
  CONCLUSIONS
  Limb salvage surgery with chemotherapy is a viable treatment option for patients with malignant fibrous histiocytoma of bone. It achieves higher survival rates than resection alone. Such therapy improves quality of life and provides a useful and functional limb.
authors.affiliation: Department of Orthopaedics and Trauma, Madras Medical College and Research Institute, Government General Hospital, Chennai, India. drmayilnatarajan@gmail.com
authors.forename: M V
authors.initials: MV
authors.lastname: Natarajan
authors.forename: P
authors.initials: P
authors.lastname: Mohanlal
authors.forename: J C
authors.initials: JC
authors.lastname: Bose
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D001859:Bone Neoplasms / Q000188:drug therapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D051677:Histiocytoma, Malignant Fibrous / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019736:Prostheses and Implants; D015996:Survival Rate; D016896:Treatment Outcome