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目的评价采用保肢和截肢术结合化疗对Ⅱ期四肢骨肉瘤患者的临床疗效。方法分析1996年1月～2007年7月山西医科大学第二医院骨科收治确诊的68例肢体骨肉瘤患者的临床资料,其中48例行保肢术治疗,20例行截肢术。术前、术后均进行化疗。63例患者获随访,随访时间6～63个月,平均38.5个月。将随访时间达3年的53例骨肉瘤患者分为保肢组和截肢组,以3年生存率、局部复发率以及术后的功能恢复评价为指标进行比较。结果在53例肢体骨肉瘤患者中,保肢组3年生存率为51.4%,局部复发率为8%,按照国际保肢协会推荐使用的肿瘤术后功能重建评价系统平均为26分。截肢组3年生存率为50%,局部复发率为6%,术后功能评分平均为12分。统计学检验比较保肢术和截肢术术后3年生存率无显著性差异(P>0.05)。结论在术前、术后辅助化疗的基础上,保肢组的3年生存率、局部复发率与截肢组相似,并且保肢术后功能恢复满意,故采用保肢术治疗同期肢体骨肉瘤患者疗效优于截肢术。
Objective To evaluate the clinical efficacy of limb salvage and amputation combined with chemotherapy in patients with stage Ⅱ osteosarcoma. Methods Clinical data of 68 patients with osteosarcoma confirmed by orthopedics in the Second Hospital of Shanxi Medical University from January 1996 to July 2007 were analyzed. Among them, 48 were treated with limb salvage and 20 were amputated. Preoperative and postoperative chemotherapy. Sixty-three patients were followed up for 6 to 63 months with an average of 38.5 months. Fifty-three patients with osteosarcoma who were followed up for 3 years were divided into limb salvage group and amputation group. The 3-year survival rate, local recurrence rate and postoperative functional recovery were compared as indexes. Results In 53 cases of limb osteosarcoma, the 3-year survival rate of limb salvage group was 51.4% and the local recurrence rate was 8%. According to the International Association of Salvage Bar Association, the postoperative functional reconstruction evaluation system of tumor was 26 points on average. Amputation group 3-year survival rate was 50%, the local recurrence rate was 6%, postoperative functional score averaged 12 points. Statistical tests compared limb salvage and amputation 3-year survival rate was no significant difference (P> 0.05). Conclusions On the basis of preoperative and postoperative adjuvant chemotherapy, the 3-year survival rate and local recurrence rate of the limb salvage group are similar to that of the amputation group, and the functional recovery after the salvage operation is satisfactory. Therefore, limb salvage therapy for patients with osteosarcoma Efficacy than amputation.