Paediatric Bone Tumours: Salvage vs Amputation - Heath Taylor 16/5/2002

Author

Kumta et al ( Hong Kong )

Title

Scope and Limitations of Limb Sparing surgery in childhood Sarcomas

Reference

JPO 2002; 22:244-248

Summary

43 pts, age 4/12 — 13y. Show that using neoadj chemo pre-op is a good thing, as it reduces recurrence and allows for limb salvage. Indications for amputation are if tumour free margins are not possible, the tumour is very invasive or distal, or the advantage of salvage is doubtful

Critique

Small numbers, not randomised, has bias built into it to make the salvage pt—s seem better than they really are

Author

Bacci et al ( Bologna , Italy )

Title

Osteosarcoma of the Limb — Amputation or Limb Salvage in patients treated by Neoadjuvant Chemotherapy

Reference

JBJS (Br) 2002; 84-B:88-92

Summary

560 patients from 1 unit. Show that limb salvage is a viable option, if clear resection margins are achieved, and the tumour is chemo sensitive.

Critique

Not randomised, and has inherent bias. Different chemo regimes

Author

Grimer & Carter ( Birmingham ))

Title

Paediatric Surgical Oncology — Bone Tumours

Reference

Europ J Surg Oncol. 1995; 21: 217 - 222

Summary

An excellent review article, giving an idiots guide to diagnosis, imaging, staging, biopsy, treatment and results