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Pasteurized Autograft-Prosthesis Composite Reconstruction May Not Be a Viable Primary Procedure for Large Skeletal Defects after Resection of Sarcoma.
- Source :
-
Sarcoma . 6/4/2017, p1-9. 9p. 4 Charts, 2 Graphs. - Publication Year :
- 2017
-
Abstract
- Background. Among various types of composite biological reconstruction, pasteurized autograft-prosthesis composite (PPC) is popular when allograft is unavailable. Previous limited cohort study indicated result comparable to tumor prosthesis. However, as case number and follow-up increase, we experienced more complications than anticipated. We questioned the usefulness of PPC as a viable reconstructive option. Methods. We reviewed 142 PPCs and analyzed overall and location-related survival and factors associated with the failure of PPC. Results. Twenty-year survival rate of 142 PPCs was 39.8 ± 10.0%. Fifty-two (36.6%) of 142 PPCs showed failure. Among various locations, the proximal femur showed best survival: 78.0 ± 9.9%. Final status of the 52 failed PPCs was modular tumor prosthesis in 23 (43%), arthrodesis in 11 (21%), pseudarthrosis in 7 (13%), amputation in 7 (13%), and allograft-prosthesis composite in 4 (8%). Tumor volume > 200 cc (p=0.001), pasteurization length ≤ 10 cm (p=0.002), male sex (p=0.02), and locations in pelvis or tibia (p=0.029) were poor prognostic factors. Conclusions. Long-term survival of PPCs was below expectations. Despite the complexity of the procedure, there is little survival gain over tumor prosthesis. PPC may be indicated when a modular prosthesis is not readily available. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 1357714X
- Database :
- Academic Search Index
- Journal :
- Sarcoma
- Publication Type :
- Academic Journal
- Accession number :
- 123392480
- Full Text :
- https://doi.org/10.1155/2017/9710964