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目的 :探讨肱骨上段恶性肿瘤应用保肢手术治疗的效果。方法 :18例肱骨上段恶性肿瘤包括原发性恶性 14例、转移性 4例 ,分别采用肿瘤边缘切除 6例、广泛切除人工假体置换 7例、上臂短缩上移成形 5例的保肢手术 ,其中 9例结合术前后化疗与放疗。结果 :17例随访 5个月～ 12年 ,平均 5年 3个月。 2年内复发 2例 (后行肩胛带离断术 ) ,因转移死亡 4例 ,存活 13例 ,2年存活率为 76 5 %。 5年仍健在 8例 ,5年生存率为 47%。Enneking分期 ,Ⅰb 4例 ,Ⅱb 3例 ,转移癌 1例 ,且患肢保留大部分功能。结论 :肱骨上段低度恶性肿瘤 (Ⅰa、Ⅰb期 ) ,对化疗或放疗敏感的高度恶性肿瘤 (Ⅱa、Ⅱb期 )与部分转移癌 ,应用保肢手术治疗可获得较满意的疗效。
Objective: To investigate the effect of limb salvage surgery on malignant tumors of the upper humerus. Methods: Eighteen cases of upper humerus malignant tumor including 14 cases of primary malignant tumor and 4 cases of metastasis were treated by resection of tumor margin in 6 cases, extensive resection of artificial prosthesis in 7 cases and upper arm shortening in 5 cases , Of which 9 cases combined with preoperative and postoperative chemotherapy and radiotherapy. Results: 17 cases were followed up for 5 months to 12 years with an average of 5 years and 3 months. Two cases of recurrence within 2 years (posterior shoulder girdle disconnection), 4 patients died of metastasis, 13 patients survived, 2-year survival rate was 76.5%. 5 years still alive in 8 cases, 5-year survival rate was 47%. Enneking staging, Ⅰ b 4 cases, Ⅱ b 3 cases, 1 case of metastatic cancer, and the limb retained most of the features. Conclusion: The lower humerus (Ⅰa, Ⅰb), highly malignant tumors (stage Ⅱa, Ⅱb) sensitive to chemotherapy or radiotherapy and some metastatic carcinoma, the satisfactory results can be obtained by limb salvage surgery.