Limb salvage in bone sarcomas in patients younger than age 10: a 20-year experience.

Department of Orthopedic, University of Navarra, Pamplona, Spain.
Journal of Pediatric Orthopaedics (Impact Factor: 1.16). 01/2003; 23(6):753-62. DOI: 10.1097/00004694-200311000-00013
Source: PubMed

ABSTRACT The authors present their experience over the last 20 years in limb salvage procedures of a consecutive series of 40 children under 10 years of age (range 2-10 years) with bone sarcomas. Nineteen were osteogenic sarcomas and 21 were Ewing sarcomas. Only one case, located in the distal phalanx of the toe, was treated by straightforward amputation. Intercalary allografts and Canadell's technique were used to preserve joints whenever possible, and prosthesis or osteoarticular allografts were used when the joint surface was involved. Survival rate in this series was 75%. There were four local recurrences. At the last follow-up (mean 11.2 years, range 5-19 years postop), 90% of the patients preserved their limbs. Eighty percent of the authors' results were excellent or good according to the Musculoskeletal Tumor Society Scale. Limb salvage is a real possibility even in young children with bone sarcomas. The age of the patient itself is not a contraindication for limb salvage.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Primary malignant bone tumours are rare but are one of the most common malignancies in adolescents. The optimum management of a child with a bone tumour is at a specialist treatment centre by a multidisciplinary team experienced in the diagnosis, chemotherapy and surgical management of these conditions. Most tumours are treated with chemotherapy followed by surgery. The surgical aim is to completely resect the tumour whilst ideally preserving the limb and maintaining function. The perfect limb salvage operation that restores normal function with no long term morbidity is rarely possible and most operations will restore function with potential long term complications. The variety of techniques possible for limb salvage includes the use of prostheses, allografts, reimplantation of sterilised bone or use of vascularised bone. Extendible prostheses are now common place and can maintain limb length following tumour resection even in the young child. Assessing outcomes is notoriously difficult but various measures are starting to allow comparisons of long term outcomes for this group of patients.
    Cancer Treatment Reviews 03/2010; 36(4):342-7. · 6.02 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Preservation of limb function in pediatric oncology patients is challenging with the ongoing growth of limbs contralateral to reconstructed limbs. We analyzed 22 patients younger than 10 years old who received an allograft after resection of a bone sarcoma with a minimum followup of 2 years (mean, 4 years; range, 2-14 years). The mean age was 7 years (range, 2-10 years). There were 16 boys and six girls with 17 osteosarcomas and five Ewing's sarcomas. Thirteen reconstructions were performed with an intercalary allograft and nine with an osteoarticular allograft. Physes were uninvolved in five patients and one physis in 17. We documented outcomes using the Musculoskeletal Tumor Society functional and the International Society of Limb Salvage radiographic scoring systems. At last followup, three of the 22 patients died of their tumor, one was alive but with an amputation, and 18 retained their limbs. These 18 patients had an average functional score of 27 points and a mean radiographic score of 94%. Eight complications required a second surgery; in four, the allograft was removed (one infection, one local recurrence, two fractures) and in four, the allograft was preserved (two local recurrences, one fracture, one nonunion). We consider biologic reconstruction with allografts after sarcoma resection an appropriate reconstructive procedure in young children. LEVEL OF EVIDENCE: Level IV, therapeutic study.
    Clinical Orthopaedics and Related Research 09/2008; 466(8):1856-62. · 2.79 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The feasibility of distal femur epiphysis preservation through epiphyseal distraction by external fixator in childhood osteosarcoma was explored.
    World Journal of Surgical Oncology 08/2014; 12(1):251. · 1.09 Impact Factor


Available from
May 20, 2014