Outcomes of limb salvage surgery in patients with extremity osteosarcoma.

Senthil Kumar, G (2009) Outcomes of limb salvage surgery in patients with extremity osteosarcoma. Masters thesis, Cancer Institute (WIA), Chennai.


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INTRODUCTION : Osteosarcoma is the most common malignant neoplasm of bone1 . It occurs most often in bones around knee joint and humerus of young people. Due to rapid and aggressive nature of the disease, the traditional treatment for osteosarcoma was amputation of the affected limb. In the 1970s, two year survival rates were fifteen to twenty percent2. However over the past 3 decades, the prognosis for these patients has changed dramatically. The development of chemotherapy agents have revolutionised the treatment of osteosarcoma by reducing the mortality. In addition the advances in imaging and new materials have provided the surgeon broader range of operative alternatives. AIMS AND OBJECTIVES : 1. To study long term survival of patients with extremity osteosarcoma treated by limb salvage surgery. 2. To identify prognostic factors influencing survival. 3. To identify risk factors for local recurrence. 4. To assess functional assessment of patients following limb salvage Surgery. CONCLUSION : Treatment of osteosarcoma has seen a paradigm shift in the management and today limb salvage surgery is possible in a majority of patients. Survival outcomes are excellent in our study and in par with international standards. Needle biopsy is the preferred method of obtaining diagnosis, preferably to be done by the centre planning the definitive treatment. Tumor response to neoadjuvant chemotherapy is the most important and valid prognostic factor predicting survival. Extensive soft tissue involvement and tumor necrosis following neoadjuvant chemotherapy were found to be risk factors, for the increased local recurrence, that has been observed in this study. In patients with extensive soft tissue extension, limb salvage surgery can be considered if technically feasible, although they have decreased survival similar to patients undergoing amputations. Our study has got its limitations as the results of the analysis of this group of patients are not statistically significant and due to lesser number of patients. The influence of this subgroup of patients undergoing limb salvage surgery, on local recurrence and survival needs to be validated in a prospective study involving more number of patients. Functional outcome after limb salvage surgery is excellent in our patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: limb salvage surgery ; patients ; extremity osteosarcoma.
Subjects: MEDICAL > Surgical Oncology
Depositing User: Kambaraman B
Date Deposited: 26 Jul 2017 02:37
Last Modified: 02 Oct 2017 04:19
URI: http://repository-tnmgrmu.ac.in/id/eprint/2125

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