Abstract
Introduction
The proximity of the superior tibiofibular articulation to neurovascular structures makes the management of extraosseous tumours of the proximal fibula challenging in bone tumour surgery. The aim of study is to establish whether the recurrence rates are higher in this anatomical area compared to data that already exists in publication for bone tumours throughout the appendicular skeleton.
Method
A retrospective study of all patients treated for Ewing's tumours and osteosarcoma at a regional bone tumour unit between January 1995 and December 2009 was conducted.
Results
Between January 1995 and December 2009, 17 patients with proximal fibular Ewing's tumours and osteosarcoma were managed surgically at a regional bone tumour unit. The overall recurrence rate of proximal fibular Ewings and osteosarcoma was found to be 29.4% and the overall 5 year survival was 70.5%. When separating the data according to tumour type, the results in this study demonstrated a recurrence rate of 50% for osteosarcoma and 11.1% for Ewing's Tumours. Five year survival was 50% for osteosarcoma and 88.9% for Ewing's tumours.
Conclusion
This series demonstrated that aggressive bone tumours of the proximal fibula are a difficult entity to manage and recurrence rates and patient survival for osteosarcoma are poor when compared to published rates for the rest of the appendicular skeleton. While local surgical treatment and adjuvant therapy remain the standard treatment we recommend more radical tumour resection and post-operative radiotherapy for osteosarcoma of the proximal fibula.
