J Korean Orthop Assoc.  2016 Oct;51(5):418-425. 10.4055/jkoa.2016.51.5.418.

Results of Clinical and Oncological Outcomes in Treatment of the Humerus Malignant Bone Tumor: Comparison according to the Treatment Methods

• Shim BJ
• Shin DS
• Ryu SM
• Park JW

• KMID: 2355507
• DOI: http://doi.org/10.4055/jkoa.2016.51.5.418

Abstract

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.

Keyword

humerus; tumor; malignant; outcomes assessment

MeSH Terms

Bone Transplantation
Chondrosarcoma
Curettage
Fracture Fixation, Intramedullary
Humans
Humerus*
Liver Neoplasms
Lung Neoplasms
Methods*
Osteosarcoma
Outcome Assessment (Health Care)
Prostheses and Implants
Retrospective Studies
Survival Rate
Urinary Bladder Neoplasms

Figure

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  Figure 1 Survival rate using Kaplan-Meier method.

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  Figure 2 Treatment of osteosarcoma patients.

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  Figure 3 Treatment of parosteal osteosarcoma patients.

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  Figure 4 Treatment of a metastatic malignant tumor patient with intramedullary nailing.

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  Figure 5 Treatment of a metastatic malignant tumor patient with open reduction and plate fixation.

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  Figure 6 Treatment of a metastatic malignant tumor patient with tumor prosthesis.

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