LIMB SALVAGE IN PRIMARY MALIGNANT BONE-TUMORS BY INTRAOPERATIVE MICROWAVE HEAT-TREATMENT

Objective. To use intraoperative microwave heat for the treatment of t umor-bearing bone in situ for limb-salvage in primary malignant bone t umor. Patients and Methods. Twenty-five patients with malignant bone t umor received surgical protocol for limb-salvage by wide exposure and intraoperative microwave heat treatment of tumor bone in situ. The tum or was localized at distal femur in 16 patients, proximal tibia in 5, shaft of femur in 2, and illia in 2. Results. The pathological diagnos is revealed osteosarcoma in 16 patients, parosteal osteosarcoma in 4, chondrosarcoma in 3, and leiomyosarcoma in 2. The stage of tumor was c lassified into IIB in 16 patients, IIA in 6, and IIIB in 3. The operat ive technique was wide exposure for tumor in soft tissues, protecting the surrounding normal tissue from heat injury by copper mesh, and hea ting tumor-bearing bone at 50 degrees C for 15 minutes. The patients w ere followed up from 4 to 180 months (mean, 63 months). The survival r ate of 2, 5 and 10 years was 81.3%, 70.4%, and 53.8% respectively. The functional results were less than 50% in 4 patients, between 50% and 75% in 9, and more than 75% in 12, referred to the normal function of a normal limb. The complications consisted of infection in 4 patients, pathological fracture in 4, and separation of epiphysis in 1. Oncolog ical results showed that local recurrences of tumor were in 4 patients , and 6 patients suffered from distant metastasis. Conclusion. The tre atment is an alternative to replacement by prosthesis or allograft bri dging techniques.