Early Functional Outcome of Wide Local Excision & Endoprosthetic Reconstruction for Bone Sarcoma at National Institute of Cancer Research & Hospital, Dhaka, Bangladesh

Authors

  • Kallol Dey Junior Consultant, Surgery, Khulna Specialised Hospital, Khulna.
  • Md Setabur Rahman Professor & Ex-Head of Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Dhaka.
  • Mohammad Serajus Saleheen Associate Professor, Orthopaedics Oncology and Musculoskeletal Tumor, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka.
  • Muhammad Sayeed Mahmud Assistant Professor, Orthopaedics Oncology and Musculoskeletal Tumor, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka.
  • S M Sakib Kabir Assistant Registrar, Surgery, 250 Bedded General Hospital Khulna.
  • Md Abdullah Yusuf Jamil Junior Consultant, Surgery, Department of Surgical Oncology, NICRH.
  • Suzon Kumar Mazumder Consultant, OSD, Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Dhaka.
  • Sonia Rahman Junior Consultant, Surgery, Department of Surgical Oncology, NICRH.
  • Md Abdul Munim Sarkar Assistant Professor, Surgical Oncology, Rajshahi Medical College, Rajshahi
  • Antara Paul Medical Officer, OSD, DGHS, Deputation: Department of Gynaecological Oncology, Bangladesh Medical University (BMU), Dhaka.

DOI:

https://doi.org/10.3329/jss.v26i2.86096

Keywords:

Wide Local Excision, Endoprosthetic Reconstruction, Limb Salvage Surgery

Abstract

Introduction: Wide local excision or limb salvage surgery with endoprosthetic reconstruction is widely accepted as an alternative to amputation in patients with primary bone sarcoma. Musculoskeletal Tumour Society (MSTS) scoring system developed in 1993 is widely used diseases specific evaluation tool for assessment of physical function in patients with bone sarcoma. The aim of this study is to evaluate functional outcome of patients with primary bone sarcoma who were treated with wide local excision (WLE) with endoprosthetic reconstruction (EPR) by maintaining oncological principles.

Methods: It was a prospective observational study at NICRH from July 2020 to October 2021. Out of 43 patients diagnosed with bone sarcoma, 35 patients were evaluated on the basis of the inclusion and exclusion criteria.

Results: In present study, most common 18(51.43%) histopathological types were osteosarcoma. Ewing’s sarcoma & chondrosarcoma both were 11(31.43%) and 6(17.14%) patients. WLE with EPR with primary closure was done in 25 (71.43%) patients. Both superficial wound infection & dislocation detected in only 1(2.9%) patient & it was right sided proximal femur ewing’s sarcoma. There was no wound dehiscence, DVT within first 6 months follow up postoperatively. Histopathologically all resections were R0. Patients of proximal tibia tumour group had mean MSTS score 23.5(78.33%) ± SD1.17, proximal humerus group had mean MSTS 23.4(78%) ± SD1.87, distal femur group had 22.75(75.83%) ± SD1.21 and proximal femur group had 21.87(72.91%) ± SD3.79. Higher MSTS score indicates better functional outcome. Functional outcomes are excellent in majority 23 (66%) of patients, good in 11 (31%) and poor in only 1 (3%) of patients.

Conclusions: Well planned & performed combined treatment of the patients of bone sarcoma with WLE & EPR lead to good or excellent functional results. Majority (66%) of patients return to near normal life and work with excellent functional outcome. After analyzing the results, it can be concluded that WLE & EPR provide good functional outcome after bone tumour resection.

Journal of Surgical Sciences 2022;26(2): 78-85

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Published

2022-12-31

How to Cite

Dey, K., Rahman, M. S., Saleheen, M. S., Mahmud, M. S., Kabir, S. M. S., Jamil, M. A. Y., … Paul, A. (2022). Early Functional Outcome of Wide Local Excision & Endoprosthetic Reconstruction for Bone Sarcoma at National Institute of Cancer Research & Hospital, Dhaka, Bangladesh. Journal of Surgical Sciences, 26(2), 78–85. https://doi.org/10.3329/jss.v26i2.86096

Issue

Vol. 26 No. 2 (2022)

Section

Original Articles

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