Introduction: In the late 20th century, limb salvage surgery emerged as a game-changer for treating musculoskeletal tumors, evolving with advanced techniques to offer both survival and functional preservation. The objective of the study is to discuss key metrics, such as overall survival, metastasis-free survival, local recurrence-free survival, and functional outcomes, recognizing the importance of these measures. Despite hurdles such as potential infections and implant issues, it is crucial to understand and address complications, which is also highlighted in this study.
Methods: This was a retrospective review of patients with primary malignant bone tumors from January 2017 to December 2023 and the progress was followed up till June 2024. Variables assessed included patient age, size and anatomical location of the primary tumor, metastasis, histological subtype, stage and grade of tumor, resection margins, treatment provided, functional outcome, and complications. The data were analyzed with SPSS version 27. Five-year metastasis-free survival, recurrence-free survival, and overall survival were analyzed by using the Kaplan-Meier method.
Results: A total of 115 patients were analyzed, among which the most common type of tumor was osteosarcoma, found in 79 (68.7%) patients. Out of the 115 patients, 20 (17.4%) expired, six were lost to follow-up, and the five-year overall survival rate was approximately 78% (95% CI: 69.6-87.5%). Fourteen (12.2%) patients had local recurrence, and the five-year recurrence-free survival rate was approximately 83.2% (95% CI: 74.4-92.6%). Meanwhile, 27 (23.5%) patients had distant metastasis, and the five-year metastasis-free survival rate was approximately 67.5% (95% CI: 55.3-82.3%). Complications occurred in 31 (27%) patients, with 13 (11.3%) patients having local soft-tissue-related complications.
Conclusion: We observed good survival and functional outcomes in patients treated with wide-margin excision of bone sarcomas and reconstruction with mega prostheses.
Keywords: bone sarcoma; bone tumor and limb salvage; cancer survival; joint prosthesis survivorship; surgical complication.
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