FEASIBILITY AND SHORT-TERM EFFECTIVENESS ANALYSIS OF MODIFIED RADICAL RESECTION AND RECONSTRUCTION SURGERY FOR MALIGNANT PROXIMAL HUMERUS TUMOR_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIUQing , DONGLei ,  JIANGRenbing

Department of Bone and Soft Tissue, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830000, P.R.China;

Corresponding?author：

JIANGRenbing, Email: 1911452679@qq.com

Keywords：

Proximal humerus; Bone tumor; Modified radical resection and reconstruction surgery; Shoulder function

DOI：

10.7507/1002-1892.20160271

Video：

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Objective To explore the feasibility and short-term effectiveness of the modified radical resection and reconstruction in the treatment of malignant proximal humerus tumor. Methods The relevant anatomic data from 30 normal adult shoulder joint MRI were measured to analyze the feasibility of modified radical resection and reconstruction surgery in the treatment of malignant proximal humerus tumor. Five patients with malignant proximal humerus tumor were treated by using the modified radical resection and reconstruction surgery between March 2012 and January 2016. There were 1 male and 4 females, aged from 9 to 69 years (median, 46 years). There were 4 cases of osteosarcoma (Enneking IIA in 2 cases and Enneking IIB in 2 cases) and 1 case of metastatic carcinoma (moderately differentiated adenocarcinoma). The disease duration was 7 to 12 months (mean, 9 months). Recurrence of tumor was observed after operation, and the shoulder function was assessed according to Enneking skeletal muscle tumor function scoring system. Results Radiographic results showed that modified radical resection and reconstruction surgery was feasible, which was in allowable range of the maximum longitudinal diameter ( < 29.8 mm) and depth ( < 4 mm). The operation was successfully completed in all 5 cases, and pathological examination suggested that purposes of radical resection had achieved. All patients were followed up 3 to 49 months (mean, 15.6 months). One patient had local recurrence at 12 months after operation, and a shoulder joint amputation was performed; the other 4 patients had good prosthesis survival. At last follow-up, the function of the shoulder joint was obviously recovered when compared with preoperative function; Enneking's skeletal muscle tumor function score was 25.8 points (range, 24 to 27 points). Conclusion Modified radical resection and reconstruction surgery is feasible for the treatment of proximal humerus tumor, and it can maintain a good early shoulder function.

Citation： LIUQing, DONGLei, JIANGRenbing. FEASIBILITY AND SHORT-TERM EFFECTIVENESS ANALYSIS OF MODIFIED RADICAL RESECTION AND RECONSTRUCTION SURGERY FOR MALIGNANT PROXIMAL HUMERUS TUMOR. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(11): 1321-1325. doi: 10.7507/1002-1892.20160271 Copy

1.	Kaa AK, J?rgensen PH, S?jbjerg JO, et al. Reverse shoulder replacement after resection of the proximal humerus for bone tumours. Bone Joint J, 2013, 95-B(11): 1551-1555.
2.	Teunis T, Nota SP, Hornicek FJ, et al. Outcome after reconstruction of the proximal humerus for tumor resection: a systematic review. Clin Orthop Relat Res, 2014, 472(7): 2245-2253.
3.	van de Sande MA, Dijkstra PD, Taminiau AH. Proximal humerus reconstruction after tumour resection: biological versus endoprosthetic reconstruction. Int Orthop, 2010, 35(9): 1375-1380.
4.	Malawer MM, Meller I, Dunham WK. A new surgical classification system for shoulder-girdle resections. Analysis of 38 patients. Clin Orthop Relat Res, 1991, (267): 33-44.
5.	Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res, 1993, (286): 241-246.
6.	翁曉軍, 廖前德, 李曉聲, 等.肱骨近段腫瘤人工假體置換的臨床分析.中南大學學報(醫學版), 2016, 41(1): 83-87.
7.	Bonnevialle N, Mansat P, Lebon J, et al. Reverse shoulder arthroplasty for malignant tumors of proximal humerus. J Shoulder Elbow Surg, 2015, 24(1): 36-44.
8.	Guven MF, Aslan L, Botanlioglu H, et al. Functional outcome of reverse shoulder tumor prosthesis in the treatment of proximal humerus tumors. J Shoulder Elbow Surg, 2015, 25(1): e1-e6.
9.	Malawer MM, Kellar-Graney K. Soft tissue reconstruction after limb-sparing surgery for tumors of the upper and lower extremities. Operative Techniques in Orthopaedics, 2004, 14(4): 276-287.
10.	Zheng K, Peng ZX, Zheng PP. Chondrosarcoma of the proximal humerus secondary to ollier disease: an 8-year follow-up of successful resection of the tumor with endoprosthetic replacement of the proximal humerus. J Clin Med Res, 2014, 6(3): 218-222.
11.	Wang B, Wu Q, Liu J, et al. Endoprosthetic reconstruction of the proximal humerus after tumour resection with polypropylene mesh. Int Orthop, 2015, 39(3): 501-506.
12.	Tang X, Guo W, Yang R, et al. Synthetic mesh improves shoulder function after intraarticular resection and prosthetic replacement of proximal humerus. Clin Orthop Relat Res, 2015, 473(4): 1464-1471.
13.	湯小東, 郭衛, 楊榮利, 等.肱骨近端腫瘤關節內切除假體置換術中應用人工韌帶重建肩周軟組織可提高肩關節功能.中華肩肘外科電子雜志, 2015, 3(2): 39-45.
14.	吳宏斌, 邵增務, 鄭啟新, 等.人工補片肩關節囊重建防治腫瘤型人工肱骨頭假體脫位.臨床骨科雜志, 2008, 11(5): 421-424.
15.	游木榮, 荊玨華, 于秀淳, 等.肱骨近端惡性腫瘤切除后骨缺損的重建.臨床骨科雜志, 2010, 13(4): 387-390.
16.	陳勇, 宋金綱, 楊蘊, 等.惡性腫瘤關節置換中人工補片的作用.中國骨與關節雜志, 2010, 9(1): 24-28.
17.	萬榮, 張偉濱, 徐建強, 等.定制型肱骨近端假體結合人工補片重建肩關節的療效分析.中華骨科雜志, 2011, 31(6): 600-604.
18.	王永貴, 劉江濤.腫瘤假體置換在肱骨近端惡性骨腫瘤治療中的應用.中國骨與關節雜志, 2014, 3(7): 511-515.
19.	郭衛, 孫馨, 燕太強, 等.保留上肢的肩胛帶切除術治療肩胛帶惡性腫瘤.中華骨科雜志, 2011, 31(6): 587-593.
20.	史思峰, 董揚, 張春林, 等.人工肩關節假體置換治療肱骨近端骨腫瘤.癌癥, 2010, 29(1): 121-124.
21.	Yang Q, Li JM, Yang ZP, et al. Limb sparing surgery for bone tumours of the shoulder girdle: the oncological and functional results. International Orthopaedics, 2010, 34(6): 869-875.

1. Kaa AK, J?rgensen PH, S?jbjerg JO, et al. Reverse shoulder replacement after resection of the proximal humerus for bone tumours. Bone Joint J, 2013, 95-B(11): 1551-1555.
2. Teunis T, Nota SP, Hornicek FJ, et al. Outcome after reconstruction of the proximal humerus for tumor resection: a systematic review. Clin Orthop Relat Res, 2014, 472(7): 2245-2253.
3. van de Sande MA, Dijkstra PD, Taminiau AH. Proximal humerus reconstruction after tumour resection: biological versus endoprosthetic reconstruction. Int Orthop, 2010, 35(9): 1375-1380.
4. Malawer MM, Meller I, Dunham WK. A new surgical classification system for shoulder-girdle resections. Analysis of 38 patients. Clin Orthop Relat Res, 1991, (267): 33-44.
5. Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res, 1993, (286): 241-246.
6. 翁曉軍, 廖前德, 李曉聲, 等.肱骨近段腫瘤人工假體置換的臨床分析.中南大學學報(醫學版), 2016, 41(1): 83-87.
7. Bonnevialle N, Mansat P, Lebon J, et al. Reverse shoulder arthroplasty for malignant tumors of proximal humerus. J Shoulder Elbow Surg, 2015, 24(1): 36-44.
8. Guven MF, Aslan L, Botanlioglu H, et al. Functional outcome of reverse shoulder tumor prosthesis in the treatment of proximal humerus tumors. J Shoulder Elbow Surg, 2015, 25(1): e1-e6.
9. Malawer MM, Kellar-Graney K. Soft tissue reconstruction after limb-sparing surgery for tumors of the upper and lower extremities. Operative Techniques in Orthopaedics, 2004, 14(4): 276-287.
10. Zheng K, Peng ZX, Zheng PP. Chondrosarcoma of the proximal humerus secondary to ollier disease: an 8-year follow-up of successful resection of the tumor with endoprosthetic replacement of the proximal humerus. J Clin Med Res, 2014, 6(3): 218-222.
11. Wang B, Wu Q, Liu J, et al. Endoprosthetic reconstruction of the proximal humerus after tumour resection with polypropylene mesh. Int Orthop, 2015, 39(3): 501-506.
12. Tang X, Guo W, Yang R, et al. Synthetic mesh improves shoulder function after intraarticular resection and prosthetic replacement of proximal humerus. Clin Orthop Relat Res, 2015, 473(4): 1464-1471.
13. 湯小東, 郭衛, 楊榮利, 等.肱骨近端腫瘤關節內切除假體置換術中應用人工韌帶重建肩周軟組織可提高肩關節功能.中華肩肘外科電子雜志, 2015, 3(2): 39-45.
14. 吳宏斌, 邵增務, 鄭啟新, 等.人工補片肩關節囊重建防治腫瘤型人工肱骨頭假體脫位.臨床骨科雜志, 2008, 11(5): 421-424.
15. 游木榮, 荊玨華, 于秀淳, 等.肱骨近端惡性腫瘤切除后骨缺損的重建.臨床骨科雜志, 2010, 13(4): 387-390.
16. 陳勇, 宋金綱, 楊蘊, 等.惡性腫瘤關節置換中人工補片的作用.中國骨與關節雜志, 2010, 9(1): 24-28.
17. 萬榮, 張偉濱, 徐建強, 等.定制型肱骨近端假體結合人工補片重建肩關節的療效分析.中華骨科雜志, 2011, 31(6): 600-604.
18. 王永貴, 劉江濤.腫瘤假體置換在肱骨近端惡性骨腫瘤治療中的應用.中國骨與關節雜志, 2014, 3(7): 511-515.
19. 郭衛, 孫馨, 燕太強, 等.保留上肢的肩胛帶切除術治療肩胛帶惡性腫瘤.中華骨科雜志, 2011, 31(6): 587-593.
20. 史思峰, 董揚, 張春林, 等.人工肩關節假體置換治療肱骨近端骨腫瘤.癌癥, 2010, 29(1): 121-124.
21. Yang Q, Li JM, Yang ZP, et al. Limb sparing surgery for bone tumours of the shoulder girdle: the oncological and functional results. International Orthopaedics, 2010, 34(6): 869-875.

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Chinese Journal of Reparative and Reconstructive Surgery

FEASIBILITY AND SHORT-TERM EFFECTIVENESS ANALYSIS OF MODIFIED RADICAL RESECTION AND RECONSTRUCTION SURGERY FOR MALIGNANT PROXIMAL HUMERUS TUMOR

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