Indications and contraindications for limb-salvage surgery in patients with bone cancer

Limb-salvage surgery can be said to be the main method and main development direction for the treatment of bone cancer, which includes extensive tumor resection, reconstruction of bone and soft tissue defects, and reconstruction of limb function. Of course, bone cancer patients should pay attention to its indications and contraindications when choosing limb-salvage surgery.

Indications for limb salvage surgery:

① Enneking stage IA, IB, ⅡA and stage ⅡB tumors in the limbs, pelvis and shoulders that respond well to chemotherapy.

② Malignant bone tumors without major neurovascular involvement, pathological fractures, or diffuse skin infiltration

③ The general condition and local soft tissue conditions are good, the surgical boundaries of radical or extensive resection can be achieved, and the local recurrence rate is expected to be no higher than that of amputees.

④ With good reconstruction technology and reconstruction conditions, the function of the retained limb is expected to be better than the prosthesis installed after amputation.

⑤ Patients with no metastatic lesions or with a single metastatic lesion that can be cured by extensive resection after systemic chemotherapy.

⑥ Patients and their families request limb salvage, have the financial means and can actively cooperate with treatment.

Contraindications to limb salvage therapy:

① The tumor is extensive and cannot be extensively or marginally resected (except for chemotherapy-sensitive patients).

② The tumor has reached an advanced stage and has extensive metastasis, and the expected survival rate is less than 6 months.

③ Radiotherapy or repeated surgeries lead to poor local skin, soft tissue and blood supply conditions, which may lead to difficulty in incision closure or skin and soft tissue necrosis after surgery.

④ Active infection still exists in the local area of ​​the tumor or other parts.

⑤ Those who are in poor general condition and have difficulty tolerating major surgery.