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目的探讨保肢手术对伴病理性骨折的原发恶性骨肿瘤的治疗效果。方法伴病理性骨折的原发恶性肿瘤患者29例,所有患者均接受规律化疗及保肢手术。对所有患者按照骨折类型、骨折时间、手术的类型进行分组。分析各临床因素与术后原位复发率与肺转移率的关系。结果平均随访18个月(10~45个月),仅2例由于复发需要截肢(6%),5例发生肺转移(17%),最终死亡。结论伴病理性骨折的原发恶性骨肿瘤并不是患者行保肢手术的禁忌证,广泛切除重建和辅助化疗可以作为保肢治疗的方案之一。
Objective To investigate the therapeutic effect of limb salvage surgery on primary malignant bone tumor with pathological fracture. Methods Twenty-nine patients with primary malignant tumor with pathological fracture were enrolled. All patients underwent regular chemotherapy and limb salvage surgery. All patients were grouped according to type of fracture, fracture time and type of surgery. The relationship between clinical factors and postoperative in situ recurrence and lung metastasis was analyzed. Results The patients were followed up for an average of 18 months (range, 10-45 months). Only 2 patients required amputation (6%) due to recurrence, and 5 patients developed lung metastases (17%) and eventually died. Conclusions The primary malignant bone tumor with pathological fracture is not a contraindication to limb salvage surgery. Extensive resection and adjuvant chemotherapy can be used as a salvage therapy for limb salvage.