THE SURGICAL-MANAGEMENT OF MALIGNANT BONE -TUMORS IN CHILDREN AND ADOLESCENTS - THE EXPERIENCE AT THE SAINT-ETIENNE HOSPITAL

From 1980 to 1997, seventeen children were treated for malignant bone tumors in the Department of Paediatric Surgery of the Saint-Etienne Ho spital, with an average follow-up of 6 years and 3 months (2M-17Y). Th e histologic diagnoses were osteosarcomas (12 cases) and Ewing's sarco mas (5 cases). All children were treated surgically. For the 12 lower limb tumors, the techniques used were prosthetic replacement in 7 case s (associated with bone allograft in 3 cases), amputation in 3 cases a nd isolated bone allograft in 2 cases. The two ilium tumors were treat ed by resection and reconstruction with autologous bone graft. A singl e resection was performed for the shoulder-blade Ewing's tumors and a prosthesis for the 2 proximal humerus tumors. Six children died during follow-up. The authors stress that carcinologic resection is a priori ty before functional results. They insist on the mechanical failures o f implants and on the difficulties of reoperations.