title: Clinical outcomes of minimally invasive surgery using acridine orange for musculoskeletal sarcomas around the forearm, compared with conventional limb salvage surgery after wide resection.
abstract: OBJECTIVE
  We recently developed and established a new surgical therapy combining photodynamic surgery and radiodynamic therapy using acridine orange (AO) therapy after marginal or intralesional tumor resection, providing excellent limb function to sarcoma patients. The present study evaluated local recurrence rate and limb function using Disability of Arm, Shoulder, and Hand (DASH) score of patients with primary musculoskeletal sarcoma around the forearm treated with AO therapy, compared to that of patients treated with conventional wide resection.
  
  
  METHODS
  Subjects were 18 patients with primary musculoskeletal sarcoma around the forearm and treated with AO therapy (AO: n = 8) after marginal or intralesional resection, or conventional wide resection followed by limb reconstruction surgery (WR: n = 10).
  
  
  RESULTS
  Mean age of the 18 patients was 45 years, and mean durations of follow-up for Groups AO and WR were 67 and 74.1 months. Local recurrence rates for AO and WR were 12.5% and 20% (P = 0.63), DASH disability scores were 3.9 and 21 (P = 0.04), and 5-year survival rates were 100% and 90% (P = 0.40), respectively.
  
  
  CONCLUSIONS
  AO therapy offers maintenance of excellent upper limb function and inhibition of local tumor recurrence, representing a useful modality for limb salvage surgery in patients with sarcoma around the forearm.
authors.affiliation: Department of Orthopaedic Surgery, Mie Postgraduate School of Medicine, Tsu City, Mie Prefecture, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Matsubara
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kusuzaki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumine
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Murata
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nakamura
authors.forename: Atsumasa
authors.initials: A
authors.lastname: Uchida
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sudo
mesh_terms: D000165:Acridine Orange / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005542:Forearm; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010778:Photochemotherapy; D012509:Sarcoma / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000165:Acridine Orange