Pathologic fracture as a complication in the treatment of Ewing's sarcoma
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作者:
Fuchs, B
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Mayo Clin & Mayo Fdn, Dept Orthoped, Div Orthoped Oncol, Rochester, MN 55905 USAMayo Clin & Mayo Fdn, Dept Orthoped, Div Orthoped Oncol, Rochester, MN 55905 USA
Fuchs, B
[1
]
Valenzuela, RG
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Mayo Clin & Mayo Fdn, Dept Orthoped, Div Orthoped Oncol, Rochester, MN 55905 USAMayo Clin & Mayo Fdn, Dept Orthoped, Div Orthoped Oncol, Rochester, MN 55905 USA
Valenzuela, RG
[1
]
Sim, FH
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Mayo Clin & Mayo Fdn, Dept Orthoped, Div Orthoped Oncol, Rochester, MN 55905 USAMayo Clin & Mayo Fdn, Dept Orthoped, Div Orthoped Oncol, Rochester, MN 55905 USA
Sim, FH
[1
]
机构:
[1] Mayo Clin & Mayo Fdn, Dept Orthoped, Div Orthoped Oncol, Rochester, MN 55905 USA
The purpose of the current study was to define the outcome of patients with Ewing's sarcoma who sustained a fracture either at initial presentation or subsequent to multimodal treatment, and to identify parameters that may influence the treatment of these patients. The age of the 21 males and 14 females who sustained a fracture during the treatment for Ewing's sarcoma averaged 15 years (range, 4-30 years) at diagnosis. Fourteen patients presented with a pathologic fracture, whereas 21 patients had a fracture develop subsequent to the initial treatment at a mean of 4 years (range, 1-19 years). The femur was the most common location (50%). At a mean followup of 10 years (range, 1-33 years), 21 of 35 patients (60%) were alive and free of disease. There was no local recurrence, but there was one postradiation sarcoma associated with the fracture. Comparing the followup of patients who sustained the fracture at presentation with the followup of patients who subsequently had a fracture, no statistically significant difference was found (117 months versus 124 months). Overall, pathologic fracture in association with Ewing's sarcoma does not seem to be a negative prognostic parameter with respect to survival in this series. Therefore, a fracture at presentation may not mandate amputation. However, it occurs frequently subsequent to initial multimodal treatment because of delayed fracture healing. Because conservative or minimal osteosynthesis have high failure rates, more aggressive resection and reconstruction have to be considered carefully.
机构:
Kyushu Univ, Grad Sch Med Sci, Dept Orthoped Surg, Higashi Ku, Fukuoka 8128582, JapanKyushu Univ, Grad Sch Med Sci, Dept Orthoped Surg, Higashi Ku, Fukuoka 8128582, Japan
机构:
Dalian Med Univ, Dept Pathophysiol, Dalian, Liaoning, Peoples R China
Dalian Med Univ, Affiliated Hosp 1, Dept VIP, Dalian, Liaoning, Peoples R ChinaDalian Med Univ, Dept Pathophysiol, Dalian, Liaoning, Peoples R China
Yu, Hongjiu
Ge, Yonggui
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Dalian Med Univ, Dept Pathophysiol, Dalian, Liaoning, Peoples R ChinaDalian Med Univ, Dept Pathophysiol, Dalian, Liaoning, Peoples R China
Ge, Yonggui
Guo, Lianying
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Dalian Med Univ, Dept Pathophysiol, Dalian, Liaoning, Peoples R ChinaDalian Med Univ, Dept Pathophysiol, Dalian, Liaoning, Peoples R China
Guo, Lianying
Huang, Lin
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Dalian Med Univ, Dept Pathophysiol, Dalian, Liaoning, Peoples R ChinaDalian Med Univ, Dept Pathophysiol, Dalian, Liaoning, Peoples R China