A retrospective multi-institutional study of 227 patients with osteosarcoma of the distal end of the femur was done to compare rates of local recurrence, metastasis, and survival. 3 cohorts of patients who had had either a limb-sparing procedure, an above-the-knee amputation, or disarticulation of the hip were compared. The results revealed prevalences of 8 of 73, 9 of 115, and zero of 39 as to local recurrence; 43 of 73, 65 of 115, and 21 of 39 as to metastasis; and 33 of 73, 48 of 115, and 18 of 39 as to death. Of the 17 patients who had a local recurrence, 16 died. In the limb-salvage group, 18 patients required amputation, because of local recurrence in 8 and other local complications in 10. The Kaplan-Meier estimates of the percentage of patients who survived and the percentage of patients without recurrent disease showed no difference among the 3 surgical groups (Mantel-Cox test statistic: p = 0.8) after a median length of follow-up of 5 and one-half years. Various covariant adjusted estimates yielded similar results. For the entire group of patients, the rate of continuously disease-free survival was 42 per cent, and the over-all rate of survival was 55 per cent at 5 years. It appears that, compared with above-the-knee amputation or disarticulation of the hip, the use of a limb-salvage procedure for osteosarcoma of the distal end of the femur did not shorten the disease-free interval or compromise long-term survival.
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A retrospective multi-institutional study of 227 patients with osteosarcoma of the distal end of the femur was done to compare rates of local recurrence, metastasis, and survival. 3 cohorts of patients who had had either a limb-sparing procedure, an above-the-knee amputation, or disarticulation of the hip were compared. The results revealed prevalences of 8 of 73, 9 of 115, and zero of 39 as to local recurrence; 43 of 73, 65 of 115, and 21 of 39 as to metastasis; and 33 of 73, 48 of 115, and 18 of 39 as to death. Of the 17 patients who had a local recurrence, 16 died. In the limb-salvage group, 18 patients required amputation, because of local recurrence in 8 and other local complications in 10. The Kaplan-Meier estimates of the percentage of patients who survived and the percentage of patients without recurrent disease showed no difference among the 3 surgical groups (Mantel-Cox test statistic: p = 0.8) after a median length of follow-up of 5 and one-half years. Various covariant adjusted estimates yielded similar results. For the entire group of patients, the rate of continuously disease-free survival was 42 per cent, and the over-all rate of survival was 55 per cent at 5 years. It appears that, compared with above-the-knee amputation or disarticulation of the hip, the use of a limb-salvage procedure for osteosarcoma of the distal end of the femur did not shorten the disease-free interval or compromise long-term survival.
Copyright remains with the authors and publisher.