Endoproteses Tumorais

Benefits and Disadvantages of Tumor Endoprostheses applied to Osteo- and Ewing’s sarcoma

Catarina D. Ferreira, Cláudia Gomes, Marta Fernandes

University of Aveiro

ABSTRACT

Background

Osteosarcoma and Ewing’s Sarcoma are two of the most common types of primary bone tumors in childhood and adolescence. The main treatment for these diseases is tumor removal. Endoprostheses are used to replace the removed bone and renew all or part of the member’s function. Nevertheless, sometimes the treatment implies limb amputation. The aim of this research was to find a balance between the benefits and disadvantages of endoprostheses.

Methods

Our research was based on different articles. In one of them we found an experiment of 335 patients with osteosarcoma who underwent resection of the distal femur and endoprosthetic replacement. After six weeks, they returned for a period of intensive physiotherapy, and they were supervised with a mean follow-up of 12 years.

Results

Kaplan-Meier analysis, using any further surgery as the end-point, demonstrated a 61% estimated risk of failure at 10 years. The reasons for this included local recurrence, infection, revision, rebushing and fracture.

Conclusion

The percentage of joint endoprostheses with significantly short lifetimes has been unexpectedly high due to infections, vein thrombosis, recurrence of tumor, among others. Sometimes these consequences can lead to limb amputation. However, at the social and psychological level, the endoprostheses are preferable, since these will increase the quality of life by delaying an almost certain amputation.

Key Words: Osteosarcoma, Ewing’s sarcoma, Endoprostheses, Tumor Bone, Limb amputation.