Limb‐salvage surgery with vascular reconstruction after lower extremity sarcoma resection: A systematic review and meta‐analysis

19530 Background: Currently between 80–90% of patients with lower extremity sarcoma undergo limb salvage procedures. A few trials show that the functional quality of life is significantly higher for limb salvage surgery compared to patients with amputation. While taking quality of life and psychological consequences into account it would seem that limb salvage would be the procedure of preference; however, this difference has yet to be demonstrated in previous studies. Methods: Eighty-two long-term survivors of lower extremity sarcoma were studied to make a comparison of the overall quality of life in limb salvage and amputation patients. Forty-eight patients with limb salvage (age 14–49 years) and thirty-four patients with amputations (age 15–49 years) were studied who were at least one-year post- surgical procedure. Sensitive psychometric measures such as self-report questionnaires and visual analog scales were used to assess psychological consequences and quality of life. Results: The overall quality of life of patients with the limb salvage was significantly higher than patients with amputation (p-value < 0.01). For the quality of life questionnaire, the limb salvage patients had a higher mean value in every domain except parent-child relations. The domains that showed a significant difference between patients with limb salvage and patients with amputations are material well being, occupational relations, creative-aesthetic behavior, and sports activity. Conclusions: For patients with lower extremity sarcoma, the psychological quality of life is better for those who received the limb salvage procedure. The significance of this study is that it one of the first to show that there is a direct benefit to limb salvage surgery as compared to amputation in regards to several psychological factors and total quality of life. No significant financial relationships to disclose.

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Limb-salvage surgery offers better five-year survival rate than amputation in patients with limb osteosarcoma treated with neoadjuvant chemotherapy. A systematic review and meta-analysis

Journal of Bone Oncology ◽

10.1016/j.jbo.2020.100319 ◽

2020 ◽

Vol 25 ◽

pp. 100319

Author(s):

Evgenia Papakonstantinou ◽

Alexandros Stamatopoulos ◽

Dimitrios I Athanasiadis ◽

Efstathios Kenanidis ◽

Michael Potoupnis ◽

...

Keyword(s):

Systematic Review ◽

Survival Rate ◽

Neoadjuvant Chemotherapy ◽

Limb Salvage ◽

Salvage Surgery ◽

Meta Analysis ◽

Limb Salvage Surgery

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Functional outcomes and quality of life in patients with osteosarcoma treated with amputation versus limb-salvage surgery: a systematic review and meta-analysis

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-014-2086-5 ◽

2014 ◽

Vol 134 (11) ◽

pp. 1507-1516 ◽

Cited By ~ 27

Author(s):

Jiong Mei ◽

Xiao-Zhong Zhu ◽

Zhi-Yuan Wang ◽

Xuan-Song Cai

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Limb Salvage ◽

Functional Outcomes ◽

Salvage Surgery ◽

Meta Analysis ◽

Limb Salvage Surgery

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The outcome comparison of limb salvage surgery versus amputation for high-grade osteosarcoma: A systematic review and meta-analysis of the last 7-year studies

Journal of Orthopedics Traumatology and Rehabilitation ◽

10.4103/jotr.jotr_52_19 ◽

2020 ◽

Vol 12 (1) ◽

pp. 67

Author(s):

SherlyDesnita Savio ◽

MariaFlorencia Deslivia ◽

Putu Astawa ◽

IGede Eka Wiratnaya

Keyword(s):

Systematic Review ◽

Limb Salvage ◽

Salvage Surgery ◽

Meta Analysis ◽

Limb Salvage Surgery ◽

High Grade ◽

Outcome Comparison ◽

High Grade Osteosarcoma

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Results of limb-salvage surgery with vascular reconstruction for soft tissue sarcoma in the lower extremity: Comparison between only arterial and arterovenous reconstruction

Journal of Surgical Oncology ◽

10.1002/jso.20945 ◽

2008 ◽

Vol 97 (3) ◽

pp. 216-220 ◽

Cited By ~ 27

Author(s):

Satoshi Tsukushi ◽

Yoshihiro Nishida ◽

Hideshi Sugiura ◽

Hiroatsu Nakashima ◽

Naoki Ishiguro

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Lower Extremity ◽

Limb Salvage ◽

Salvage Surgery ◽

Vascular Reconstruction ◽

Limb Salvage Surgery

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Limb salvage surgery in pediatric and AYA patients with osteosarcoma: The incidence of venous thrombosis (VT).

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e22505 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e22505-e22505

Author(s):

Sarah Jane McKillop ◽

Quincy S. Chu ◽

Karen E. Mulder ◽

Mary E Bauman ◽

Ashley Crosty

Keyword(s):

Lower Extremity ◽

Venous Thrombosis ◽

Limb Salvage ◽

Surgical Resection ◽

Local Control ◽

Salvage Surgery ◽

Adolescent And Young Adult ◽

Limb Salvage Surgery ◽

Increased Risk ◽

Prophylactic Anticoagulation

e22505 Background: Pediatric, adolescent and young adult (AYA) patients with a diagnosis of osteosarcoma require surgical resection for local control in addition to adjuvant chemotherapy. Limb salvage surgery (LSS) has long been established as the standard of care. Pediatric and AYA patients with sarcoma are know to have an increased risk of VTE however thromboprophylaxis is not routinely used in the pediatric oncology patients. Here we review our experience over a 5 year period with patients up to 21 years diagnosed with osteosarcoma of the lower extremity treated with LSS, amputation or rotationplasty as local control and the development of VTE. Methods: A retrospective chart review was completed of patients up to 21 years of age treated for osteosarcoma of the lower extremity between January 2011 and December 2016 at our institutions. Those that underwent surgical resection of the tumor were included. Data regarding age, type of surgical procedure, the presence of a venous thrombosis, the time from diagnosis and surgery to detection of VTE and the use of anticoagulants was collected Results: 18 patients were identified: median age 14 year (6-21), 8 patients had LSS, 4 underwent rotationplasty and 6 had an amputation. Seven VTE were identified, 5 occurred in patients receiving LSS, 2 in a patient post rotationplasty and 0 in the amputation group. 6 of the 7 VTE occurred within the upper venous system, associated with the central venous line. Conclusions: In pediatric AYA patients being treated for lower limb osteosarcoma, the incidence of VTE was significantly increased for those undergoing LSS (63%) and rotationplasty (50%) compared to those receiving amputation (0%). While the population reviewed is small, based on these findings, prophylactic anticoagulation for patients with osteosarcoma, especially those patients undergoing LSS and rotationplasty should be considered beyond the immediate perioperative period. Larger prospective studies are needed to determine the risk of VTE and risks and benefits of prophylactic anticoagulation in this patient population.

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Limb salvage surgery of primary and metastatic bone tumors of the lower extremity: Functional outcomes and survivorship of modular endoprosthetic reconstruction

Acta Orthopaedica et Traumatologica Turcica ◽

10.5152/j.aott.2021.20101 ◽

2021 ◽

Vol 55 (2) ◽

pp. 147-153

Author(s):

Osman Mert Topkar ◽

◽

Omer Sofulu ◽

Evrim Sirin ◽

Bulent Erol ◽

...

Keyword(s):

Lower Extremity ◽

Limb Salvage ◽

Functional Outcomes ◽

Bone Tumors ◽

Salvage Surgery ◽

Limb Salvage Surgery ◽

Endoprosthetic Reconstruction

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Limb Salvage Surgery of Osteosarcoma Usingliquid Nitrogen at Rsup Dr. Moh. Hoesin Palembang: A Case Series

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v8i04.03 ◽

2021 ◽

Vol 8 (04) ◽

pp. 5341-5348

Author(s):

Primadika Rubiansyah ◽

Afifurrahman Rizal

Keyword(s):

Survival Rate ◽

Lower Extremity ◽

Limb Salvage ◽

Room Temperature ◽

Salvage Surgery ◽

Case Series ◽

Wide Resection ◽

Limb Salvage Surgery ◽

Grade Ii ◽

Enneking Stage

The five-year survival rate of osteosarcoma has gradually increased to 60% from 20% with Limb Salvage Surgery (LSS) combined with chemotherapy. Limb salvage surgery involves two main steps, wide resection of the bone tumor, followed by reconstruction of the defect. Reconstruction can be achieved with Cryosurgery. In this study, we presented a serial case of four patient at RSUP Dr. Moh. Hoesin Palembang with ages between 13-19 years old, 2 male and 2 females and diagnosed with Osteosarcoma Enneking stage IIB at the Lower Extremity Region that treated with Cryosurgery from October 2020- February 2021. The cryosurgery procedure on RSUP dr. Moh Hoesin Palembang, started with the bone soaked into liquid Nitrogen for 20 minutes. The bone than thawed at room temperature for 15 minutes and then soaked with normal saline in room temperature for another 15 minutes. The used of Cryosurgery for limb salvage surgery shown a good result for inducing osteosarcoma necrosis with all Histopathology results shown 50-90% to 91-99% post cryosurgery (Huvos grade II-III). The followed up however shown mixed results, with the patients have mixed knee flex ranged from 40o to 1100, but The LLD could still be preserved at 1-2 cm. During Followed up at 1-2 month postoperative, we found complication such as failure of fixation and skin necrotic. The followed-up research also still needed for long termed results, complications and for assessing the recurrency rated of the Osteosarcoma for these cases.

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