摘要 |
Osteosarcoma is the most common type of primary malignant bone cancer. Before
the 1970’s, the survival rate was dismal, and the amputation rate was nearly 100%.
However, the outcome was improved after neoadjuvant chemotherapy was started in
1976. Nowadays, the formal treatment is neoadjuvant chemotherapy following wide
excision with reconstruction and adjuvant chemotherapy, and several factors, such
as size, serum alkaline phosphatase, tumor necrosis and metastasis, are related to the
outcome. In our study. receiving previous manipvlative therapy was also an
independent survival factor. A number of options that exist for limb-salvage
reconstruction are classified as prosthetic and biological reconstructions, and we
prefer the latter method because of better longevity and function. In Taipei Veterans
General Hospital, we performed two new surgical procedures, “transphyseal
excision” and “hemicortical excision”, which resulted in good functional outcome
and no local recurrence of the tumor. As a result, the five-year survival rate was
increased to 74%, and the limb salvage rate was more than 95% in our hospital,
showing significant improvement. Osteosarcoma, which was known as a devastating
disease in the past, now appears largely curable. |