Abstract
Purpose Of The Study: To find the functional and oncological outcome of patients who underwent limb salvage surgery and custom mega prosthesis for Malignant Fibrous Histiocytoma of bone.
Methods And Results: Twenty patients with histologically diagnosed Malignant Fibrous Histiocytoma of bone were treated by resection and reconstruction with custom mega prosthesis between May 1991 and December 2002. The average age was 42 and two-thirds of the patients were males. Majority of the tumours were located around the knee and were in Stage II disease of the Enneking system. Wide margins of resection were achieved in 18 patients and reconstruction was done with total knee prosthesis in patients with distal femoral and proximal tibial tumours. The proximal humeral and proximal femoral sites were reconstructed with their respective prosthesis. Fourteen patients treated after 1996 received chemotherapy. With an average follow-up of 57.7 months, 4 patients had amputation for local recurrence and five patients died of disease. Two patients had fracture of prosthesis necessitating revision of prosthesis in one. Functional result was excellent in 5 patients and good in 9 patients. The Kaplan-Meier 5-year survival rates of the patients treated without chemotherapy and with chemotherapy were 50% and 75.8% respectively.
Conclusion: MFH is an aggressive malignant tumour with a poor prognosis. A combined approach using neoadjuvant chemotherapy together with adequate surgical margins improves survival.
The abstracts were prepared by Mrs Leslie O’Leary. Correspondence should be addressed to her at British Orthopaedic Association, 35–43 Lincoln’s Inn Fields, London WC2A 3PE or at l.oleary@boa.ac.uk
