2001 CTOS Annual Meeting Posters— Surgery

OSTEOSARCOMA OF THE PROXIMAL HUMERUS: LONG TERM RESULTS WITH LIMB SPARING SURGERY
James C Wittig¹,  Jacob Bickels²,  Kristen L. Kellar-Graney¹,  Isaac Meller²,  Martin M Malawer^1
1Division of Orthopedic Oncology Washington Cancer Institute Washington Hospital Center,  ²National Unit of Orthopedic Oncology Tel-Aviv Sourasky Medical Center

METHODS: There were 1 stage IIA lesion, 18 stage IIB lesions, and 4 stage III lesions in this study group. Twenty-two patients were treated with an extraarticular resection that included the deltoid and rotator cuff and one patient was treated with an intraarticular resection that spared the shoulder abductors. In all these patients, the proximal humerus was reconstructed with a cemented endoprosthetic replacement that was stabilized via a technique of static suspension (Dacron tapes) and dynamic suspension (muscle transfers).

RESULTS: At latest follow-up (median: 10 years), 15 patients (65%) were alive without evidence of disease. There were no local recurrences. Prosthetic survival was 100% for the 15 survivors. The Musculoskeletal Tumor Society (MSTS) upper extremity functional score ranged from 24 to 27 (80%-90%). All shoulders were stable and pain-free. Elbow and hand function were preserved in all patients. The most common complication was a transient neuropraxia (n=8).

CONCLUSION: En-bloc extraarticular resection and endoprosthetic reconstruction is a safe and reliable method of limb-sparing surgery for high-grade extracompartmental osteosarcoma of the proximal humerus.