Abstract
Background: The improvement of survival in osteosarcoma has made a demand to get the long-term durability in the reconstruction method after wide resection.
Purpose: The long-term results of intraoperative extracorporeal irradiated bone graft (IORBG) for malignant bone tumors are analyzed to know the long-term durability of this method.
Method: Seventy-two bone tumor patients treated with IORBG for the last 25 years were reviewed. The oncological results, complication, reoperation-free survival, and graft survival were analyzed.
Results: Oncological 5-year and 10 year survival rates were 90 % and 81 %. Local recurrence was detected in one case outside the implanted bone. Major complications, namely, infection, collapse, fracture, and nonunion, were seen within a short term after initial operation. The reoperation rate was as high as 43 %. The graft survival rate was 81 % at 10 years.
Discussion: Although the reoperation rate was high, complications occurred rather in a shorter term compared with that of tumor knee prosthesis (TKR). This IORBG method is less troublesome than the prosthetic replacement which needs maintenance surgery particularly after long-term follow-up. However, as osteosarcoma occurs mostly in the second decade of life, we should continue to seek a better reconstruction method.
The Osaka Orthopaedic Oncology Group comprises doctors in Department of Orthopaedic Surgery of Osaka University, Osaka National Hospital, JRC Himeji Hospital, Bell Land General Hospital, Kawachi General Hospital and Nozaki Tokushukai Hospital.
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Acknowledgment
This study was supported in part by the Health and Labour Sciences Research Expenses for Commission, Applied Research for Innovative Treatment of Cancer from the Ministry of Health, Labour and Welfare (H26-084), and by the National Cancer Center Research and Development Fund (26-A-4).
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Araki, N., Osaka Orthopaedic Oncology Group. (2016). Biological Reconstruction for Extremity Osteosarcoma: Long-Term Results and Current Concept of Intraoperative Extracorporeal Irradiated Bone Graft (IORBG). In: Ueda, T., Kawai, A. (eds) Osteosarcoma. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55696-1_13
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