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Surgical Alternatives to Standard Endoprosthetic Replacement and Allograft Reconstruction for Malignant Tumors of the Musculoskeletal System

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Recent Concepts in Sarcoma Treatment

Part of the book series: Developments in Oncology ((DION,volume 55))

Abstract

The advent of adjuvant chemotherapy modalities and limb sparing surgical techniques has permitted oncological surgeons and their patients with musculoskeletal tumors to consider a variety of limb salvage reconstructions.(1–11) The diminished role of primary amputation is illustrated by a recent analysis of 160 malignant bone tumors treated at UCLA between January 1981 and September 1986. During that period, only 23 patients (14.4%) underwent primary amputation for local control of the tumor. Tumor size alone was considered to be the indication for amputation in 13 patients, age less than 11 years with lack of skeletal naturity was considered to be the indication in 6 patients, and location in the tibia was the sole indication in 4. The remaining 137 patients (85.6%) underwent primary limb salvage procedures, with endoprosthetic reconstruction in 103 patients (64%), internal hemipelvectomy resections in 20 (12.5%), and excision alone in an additional 14 patients 8.8%). In 1983, Dubousset described the medial gastrocnemic transfer for coverage of proximal tibial replacements, and in 1984, Lewis introduced the expandable endoprosthesis.

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Author information

Authors and Affiliations

  1. Division of Orthopaedic Surgery, UCLA School of Medicine, Room A6-164/CHS Bldg., Los Angeles, CA, 90024-1749, USA

    Jeffrey J. Eckardt M.D. & Michael H. Kody M.D.

  2. Division of Surgical Oncology, UCLA Medical Center, Los Angeles, CA, USA

    Frederick R. Eilber M.D.

  3. Department of Pediatrics, UCLA Medical Center, Los Angeles, CA, USA

    Gerald Rosen M.D.

Authors
  1. Jeffrey J. Eckardt M.D.
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  2. Frederick R. Eilber M.D.
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  3. Michael H. Kody M.D.
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  4. Gerald Rosen M.D.
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Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA

    James R. Ryan MD (Associate Professor, Chief Orthopedic Oncology) (Associate Professor, Chief Orthopedic Oncology)

  2. Department of Internal Medicine, Division of Hematology-Oncology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA

    Laurence O. Baker D.O. (Professor, Director) (Professor, Director)

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© 1988 Kluwer Academic Publishers

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Eckardt, J.J., Eilber, F.R., Kody, M.H., Rosen, G. (1988). Surgical Alternatives to Standard Endoprosthetic Replacement and Allograft Reconstruction for Malignant Tumors of the Musculoskeletal System. In: Ryan, J.R., Baker, L.O. (eds) Recent Concepts in Sarcoma Treatment. Developments in Oncology, vol 55. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-2691-2_41

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  • DOI: https://doi.org/10.1007/978-94-009-2691-2_41

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-7714-9

  • Online ISBN: 978-94-009-2691-2

  • eBook Packages: Springer Book Archive

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