Recent Developments in the Surgical Treatment of Bone Tumors and Their Impact on Quality of Life

Abstract

The management of bone tumors has rapidly evolved over the last decades. Before the 1970s, amputation and arthrodesis were almost exclusively performed at the surgical theaters of tertiary tumor centers. Currently, with the evolutions in diagnostic imaging, surgical techniques, metallurgy, and adjuvant therapies, more than 90% of bone sarcomas patients are treated with limb salvage surgery. It is well documented in the related literature that limb salvage surgery does not compromise the survival of the patients. The main indication for limb salvage is the ability to obtain wide-margin (microscopically negative) surgical resection. A relative contraindication is local recurrence in a patient that previously had limb salvage surgery, except if the recurrence can be excised with wide margins. Various reconstruction options have been described following bone tumors resection with limb salvage, including megaprosthetic and biological reconstructions with allografts and vascularized bone autografts. However, what is the impact of bone tumors surgical resections and their reconstructions on the quality of life of tumor patients? This special issue tries to address the recent developments in the surgical treatment of bone tumors and their impact on quality of life. Expert authors in tumor surgery present their experience and knowledge on this subject. The treatment of bone sarcomas is based on the tumor's biology and location and the patient's expectations [1]. The reconstruction options are technically demanding, may require lengthy treatment protocols, and may be associated with complications, which are not acceptable in cancer patients. These constraints have triggered a need for new therapeutic concepts to design and engineer structural and functional bone grafts. The goal is for long-term repair and optimum clinical outcome using techniques to replace tissues with inert biological devices such as tissue engineering constructs [2, 3]. The study of Dr. B. M. Holzapfel et al. is within this context. The authors discuss the implementation of tissue engineering concepts in treatment strategies of bone defects following bone tumor resection and outline their future prospects and possible application spectrum. Massive bone allografts may be used as alternative to megaprosthetic reconstructions for bone defects after tumor resection. However, the rate of complications, namely, infection, fracture, and nonunion, may range up to 30%. Decreasing nonunion may minimize surgical exposure and permit earlier rehabilitation of the patients. While con-gruous osteotomy cuts are desirable, exact matching surfaces are rarely achieved using a freehand technique [4]. Computer-assisted navigation may provide for more accurate osteotomies resulting in more congruent …

DOI: 10.1155/2013/826432

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@inproceedings{Mavrogenis2013RecentDI, title={Recent Developments in the Surgical Treatment of Bone Tumors and Their Impact on Quality of Life}, author={Andreas F. Mavrogenis and Ulrich Lenze and Hans Rechl and George Douglas Letson and Pietro Ruggieri}, booktitle={Sarcoma}, year={2013} }