Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection?
Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection?
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DOI：
10.1016/j.jbo.2021.100401
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发表时间：
2021-12
影响因子：
3.4
通讯作者：
Jeys L
中科院分区：
文献类型：
--
作者：
Fujiwara T;Tsuda Y;Stevenson J;Parry M;Jeys L
耳部与髋关节IAR的肿瘤学和功能风险尚不清楚。EAR和IAR之间的肿瘤学结果没有统计学差异。EAR和IAR之间的并发症发生率也没有差别。没有观察到EAR和IAR之间在功能结果上的重大差异。如果影像检查显示关节肿瘤受累，应进行耳部检查。虽然膝关节和肩关节关节外切除(EAR)与较差的临床结果相关，但髋关节EAR的肿瘤学和功能风险尚不清楚。我们的目的是比较髋关节耳切除术和关节内切除术(IAR)之间的风险。我们对1996年至2016年间75例髋臼周围骨肉瘤患者进行了对比研究。我们将患者分为两组进行分析；EAR组(n=21)和IAR组(n=54)。在肿瘤学结果方面没有统计学差异；耳组和IAR组的5年疾病特异性死亡累积发生率分别为34%和35%(P=0.943)，LR的5年累积发生率分别为26%和34%(P=0.482)。最常见的并发症是脱位(28%)和深部感染(28%)；两组之间同样没有差异。肌肉骨骼肿瘤学会评分在耳科和IAR组分别为66%和65%(p=0.795)，在深度感染的患者中显著降低(52%vs.69%；p=0.013)。在对接受PI非介入PII切除术的软骨肉瘤患者的结果进行的子分析中，没有证实肿瘤学和功能结果的主要差异。与接受IAR和重建的患者相比，接受耳和保肢髋关节重建的患者在肿瘤学、临床和功能方面的结果没有明显区别。如果术前影像显示关节肿瘤受累，进行耳廓手术以优化局部控制似乎没有不良影响。
The oncological and functional risks of EAR vs. IAR of the hip joint are unknown. There was no statistical difference in oncological outcomes between EARs and IARs. There was equally no difference in complication rates between EARs and IARs. No major differences in functional outcomes between EARs and IARs were observed. EAR should be undertaken if imaging studies suggest articular tumour involvement. While extra-articular resection (EAR) of the knee and shoulder joint is associated with poorer clinical outcomes, the oncological and functional risks of EAR of the hip joint are unknown. We aimed to compare these risks between EAR of the hip joint and intra-articular resection (IAR). We conducted a comparative study of 75 patients who underwent en-bloc tumour resection and limb-salvage reconstruction for bone sarcomas of the peri-acetabulum between 1996 and 2016. We divided patients into two groups for analyses; EAR (n = 21) and IAR (n = 54). There was no statistical difference in oncological outcomes; the 5-year cumulative incidence of disease-specific death was 34% and 35% in the EAR and IAR groups, respectively (p = 0.943), and the 5-year cumulative incidence of LR was 26% and 34%, respectively (p = 0.482). The most common complications were dislocation (28%) and deep infection (28%); there was equally no difference between the groups. The mean Musculoskeletal Tumour Society score was 66% and 65% in the EAR and IAR groups, respectively (p = 0.795), and were significantly lower in patients with deep infection (52% vs. 69%; p = 0.013). In a sub-analysis on the outcomes in patients who underwent PI-uninvolved PII-resection for chondrosarcoma, no major differences in oncologic and functional outcomes were confirmed. Patients undergoing EAR and limb-salvage reconstructions of the hip joint have undistinguishable oncological, clinical and functional outcomes compared to those undergoing IAR and reconstructions. If preoperative imaging suggests articular tumour involvement, there appears to be no detrimental effect of undertaking EAR to optimise local control.
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关节外切除术是髋关节肉瘤的一种肢体挽救方案
影响因子：
2.7
作者：
Li, Dasen;Xie, Lu;Yang, Rongli
通讯作者：
Yang, Rongli
影响因子：
5.3
作者：
Jeys, L. M.;Kulkarni, A.;Abudu, A.
通讯作者：
Abudu, A.
影响因子：
4.6
作者：
Henderson, E. R.;O'Connor, M. I.;Letson, G. D.
通讯作者：
Letson, G. D.
影响因子：
3.5
作者：
Kendall, PJH;Singer, GC;Cannon, SR
通讯作者：
Cannon, SR
DOI：
10.1158/1078-0432.ccr-11-2097
发表时间：
2012-04-15
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Dignam JJ;Zhang Q;Kocherginsky M
通讯作者：
Kocherginsky M