We present the greatest study of patients with proximal fibula resection. Moreover we describe a new classification system for tumour resection of the proximal fibula independent of the tumour dignity. In 57 patients the functional and clinical outcome was evaluated. The follow up ranged between 6 months and 22.2 years (median 7.2 years). Indicationfor surgery was in 10 cases benign tumours and in 47 cases malignant tumours. In 32 patients a resection of the peroneal with resulting peroneal palsy was necessary.Aim
Method
The aim of this study was to define the treatment
criteria for patients with recurrent chondrosarcoma. We reviewed the
data of 77 patients to examine the influence of factors such as
the intention of treatment (curative/palliative), extent of surgery,
resection margins, status of disease at the time of local recurrence
and the grade of the tumour. A total of 70 patients underwent surgery
for recurrent chondrosarcoma. In seven patients surgery was not
a viable option. Metastatic disease occurred in 41 patients, appearing
synchronously with the local recurrence in 56% of cases. For patients
without metastasis at the time of local recurrence, the overall
survival at a mean follow-up after recurrence of 67 months (0 to
289) was 74% (5 of 27) compared with 19% (13 of 50) for patients
with metastasis at or before the development of the recurrence.
Neither the type/extent of surgery, site of tumour, nor the resection margins
for the recurrent tumour significantly influenced the overall survival. With limited survival for patients with metastatic disease at
the time of local recurrence (0% for patients with grade III and
de-differentiated chondrosarcoma), palliative treatment, including
local radiation therapy and debulking procedures, should be discussed
with the patients to avoid long hospitalisation and functional deficits. For
patients without metastasis at the time of local recurrence, the
overall survival of 74% justifies an aggressive approach including
wide resection margins and extensive reconstruction.