Keep limb treatment of osteosarcoma

By | April 10, 2012

1. osteosarcoma physical therapy to retain the status quo with the development of chemotherapy in the treatment of osteosarcoma, it is not only the importance of improving survival, but also paying attention to the quality of life of patients. Currently, a number of professional organizations of bone cancer treatment, physical therapy to retain more than the proportion of amputation treatment. However, not all patients are suitable for retention limb surgery. If the following conditions are required amputation:
1), vascular invasion involving the nerves.
2) and the incidence of pathologic fractures.
3) tumor huge, widespread violations of soft tissues, complete removal of difficulties, they should first consider amputation.
2. The reason why poor prognosis in osteosarcoma is extremely vulnerable because of lung metastasis, surgical treatment is a topical treatment, distant metastasis can only be resolved through chemotherapy. Sensitive to preoperative chemotherapy in patients with low risk of local recurrence; not sensitive to the patients, local recurrence rate. Surgical procedure also has some relation with the recurrence, emphasizing the sharp complete resection, excision should be adequate. Most reports indicate that physical therapy to retain the survival rate of osteosarcoma patients with no adverse effects.
3. Osteosarcoma conditions to retain physical therapy
1) standard chemotherapy: standard chemotherapy treatment carried out to preserve the body to create the conditions to retain physical treatment was built on the basis of standard chemotherapy. Preoperative systemic chemotherapy in addition to the elimination of small metastases, it also can make the tumor shrink, lower tumor stage, the scope of the removal of relatively smaller. ,
2) resection: resection of osteosarcoma histologically divided into radical resection, wide excision, marginal excision and tumor resection. Since the application of adjuvant chemotherapy, local recurrence rate is generally 5%-l0%, with no more than joint amputation of local recurrence rates were the same. If surgery is the resection margin to retain body or tumor resection, the recurrence rate is high.
3) retention of osteosarcoma limb surgery indications: by ordinary X-ray, CT, MRI and angiography and other more limited range of the tumor. no distant metastases, less soft tissue violation. The vessel and nerve involvement, no pathological fracture, no local infection or diffuse skin involvement.
4. Limb reconstruction methods are mainly the metal limb reconstruction prosthesis, allograft, vascularized autogenous bone transplantation. Prosthesis is the most widely used method, the source convenience, faster recovery, relatively few complications, can be an early event. Vascularized autogenous bone graft as a major advantage is that the graft with blood supply, bone healing relatively quickly, but the operation demanding.Osteosarcoma around the knee joint is a good site, method of reconstruction is greater.
5. The possible adverse impact of complications after treatment retention than limb amputees and more early complications and soft tissue related, post more concerned with the physical reconstruction. The most common complication was skin necrosis and infection, the upper chamber of bone tumor surgery, especially vulnerable. Complications occur not only on the negative limb reconstruction, and chemotherapy may be delayed.

Leave a Reply

Your email address will not be published. Required fields are marked *