Posters— Oncology Research

THE FUNCTIONAL AND LOCAL RESULTS OF LIMB SPARING PROCEDURES IN UPPER GIRDLE NEOPLASMS TREATMENT

Dardzinski R, Ruka W, Koziol A, Rutkowski P. Maria Sklodowska–Curie Memorial Cancer center, Warshaw, Poland Thirty one 31 patients (15 females and 16 males) were operated on in Maria Sklodowska-Curie Memorial Cancer Centre from 1980 to 1999 (together 33 operations were performed)

Mean age at operation was 37.0 years (ranging from 13 to 68 years). Fifteen tumors involved the scapula, while in 16 cases neoplasms were located in proximal humerus.

In three cases soft tissue sarcoma was diagnosed, all other cases were primary bone tumours. All patients with osteosarcoma received both pre-and post operative chemotherapy. In cases of soft tissue sarcomas neoadjuvant chemotherapy was also introduced. The follow-up periods of patients ranged from 6 to 236 months (mean 42 months).

All surgical procedures were classified according to the system elaborated by Malawer. There were six operations of the V1 type and eleven resections of the V type. Less extensive procedures were performed in 16 patients – three, seven and six operations in types I, II, and III respectively. Only in one case internal prosthesis was inserted, all other patients were operated without bone length reconstruction. External orthopaedic devices were used instead of.

The functional results were assessed according to the MSTS evaluation system including the analysis of six factors. The patients occupation and recreational abilities were particularly emphasized. Simplified , three factor evaluation scale was also introduced and compared with the MSTS system. Analysis of local recurrence as the main drawback of limb sparing surgery was performed. At the moment 22 patients are alive free of disease. Out of 9 patients who died, four deceased with symptoms of local recurrence. In two cases local recurrence was accompanied or preceeded by systemic dissemination. One patient is free of disease 84 months after reoperation of his recurrence. Together, local recurrence was observed in 5 out 31 patients (18.5). no evident correlation between local recurrence and the extent of the free margin was found. All failures concerned advanced cases—II B according to TNM staging system.

Non-oncological complications were infrequent (6/31). None of them resulted in permanent disability. Only one temporary palsy of the radical nerve was observed.

The mean functional score in accordance with MSTS rating system was 72.6% (ranging from 50% to 90%). This outcome corresponds to the data published by the others. The lack of prosthetic reconstruction resulted in inferior hand positioning, but due to the application of external devices, does not seem to effect significantly patients ability.