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KMID : 0361620160510050416
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Journal of the Korean Orthopaedic Association
2016 Volume.51 No. 5 p.416 ~ p.425
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Results of Clinical and Oncological Outcomes in Treatment of the Humerus Malignant Bone Tumor: Comparison according to the Treatment Methods
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Shim Bum-Jin
Shin Duk-Seop
Ryu Seung-Min
Park Jae-Woo
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Abstract
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Purpose: The purpose of this study was to compare the clinical and oncological outcomes between the primary and metastatic malignant tumor of humerus.
Materials and Methods: Between May 2005 and May 2014, 42 cases of malignant tumor in humerus that were followed-up for at least 1 year were entered into the study and analyzed retrospectively. Cases were divided into two groups, the primary (group 1, 15 cases) and metastatic (group 2, 27 cases), according to the origin of the tumor. The clinical and oncological outcomes between the primary and metastatic malignant tumor of humerus were analyzed and compared.
Results: In the group 1, nine cases were osteosarcoma and six cases were chondrosarcoma. The tumor lesions were distributed in the proximal area of the humerus. In the group 2, 12 cases originated from lung cancer, six cases from liver cancer, and two cases from bladder cancer. The lesions were usually distributed in the midshaft area. The patients underwent various surgical treatments, including wide excision with tumor prosthesis, curettage with bone grafting, intramedullary nailing, open reduction, and internal fixation with plate. Kaplan-Meier 5-year survival estimates were 87.5% for group 1, and 1-year survival estimates were 70.1% and 2-year survival estimates were 40.1% for group 2. The mean Musculoskeletal Tumor Society score was high in both groups. However group 1 showed a higher score on the functional index compared to group 2.
Conclusion: Primary malignant bone tumors of the humerus usually involve the proximal site and tumor prosthesis is the main treatment. The metastatic malignant bone tumor usually involves the midshaft area and intramedullary nailing and radiation therapy is the main therapy. Although treatment of the primary malignant tumor increases the survival rate, treatment of metastatic malignant tumor does not affect the survival rate, though it helps in relieving pain.
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KEYWORD
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humerus, tumor, malignant, outcomes assess
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