Advances in bone reconstructions after sarcoma resection

Abstract

Primary malignant bone tumours, or sarcomas, are rare and represent a major diagnostic and therapeutic challenge. According to the EUROCARE database, they do not exceed 0.2% of all malignancies. According to the American Cancer Society, over 40% of primary bone tumours in adults are chondrosarcomas followed by osteosarcoma (28%), chordoma (10%) Ewing sarcoma (8%), malignant histiocytic sarcoma/fibrosarcoma (4%), and the remaining percentages is distributed among several types of rare bone tumours. In children and adolescents ( < 20 years), osteosarcoma accounts for 56%, Ewing sarcoma 34% and chondrosarcoma only 6%. The best treatment results of bone sarcomas are achieved with the use of combined therapy in highly specialised centres. This combined treatment within specialised multidisciplinary teams gives the patient the greatest chance for appropriate management of their disease and increases their chances to be cured and to avoid disability. Limb sparing surgery is currently a standard in surgical treatment of bone sarcomas. This approach helps to obtain a good functional result and limits the patient’s disability. The most common methods currently used in sparing surgery include modular oncology endoprostheses (megaprostheses), non invasive growing prostheses used in children, bone auto and allografts, rotationplasties, patient specific surgical implants, arthrodesis of large joints, and in some locations only radical bone resections (shoulder, pelvis). In this short review article we present historical and contemporary methods of surgical treatment of primary bone sarcomas.