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, Jørgensen PH, Søjbjerg 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.	翁晓军, 廖前德, 李晓声, 等.肱骨近段肿瘤人工假体置换的临床分析.中南大学学报(医学版), 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.	汤小东, 郭卫, 杨荣利, 等.肱骨近端肿瘤关节内切除假体置换术中应用人工韧带重建肩周软组织可提高肩关节功能.中华肩肘外科电子杂志, 2015, 3(2): 39-45.
14.	吴宏斌, 邵增务, 郑启新, 等.人工补片肩关节囊重建防治肿瘤型人工肱骨头假体脱位.临床骨科杂志, 2008, 11(5): 421-424.
15.	游木荣, 荆珏华, 于秀淳, 等.肱骨近端恶性肿瘤切除后骨缺损的重建.临床骨科杂志, 2010, 13(4): 387-390.
16.	陈勇, 宋金纲, 杨蕴, 等.恶性肿瘤关节置换中人工补片的作用.中国骨与关节杂志, 2010, 9(1): 24-28.
17.	万荣, 张伟滨, 徐建强, 等.定制型肱骨近端假体结合人工补片重建肩关节的疗效分析.中华骨科杂志, 2011, 31(6): 600-604.
18.	王永贵, 刘江涛.肿瘤假体置换在肱骨近端恶性骨肿瘤治疗中的应用.中国骨与关节杂志, 2014, 3(7): 511-515.
19.	郭卫, 孙馨, 燕太强, 等.保留上肢的肩胛带切除术治疗肩胛带恶性肿瘤.中华骨科杂志, 2011, 31(6): 587-593.
20.	史思峰, 董扬, 张春林, 等.人工肩关节假体置换治疗肱骨近端骨肿瘤.癌症, 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, Jørgensen PH, Søjbjerg 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. 翁晓军, 廖前德, 李晓声, 等.肱骨近段肿瘤人工假体置换的临床分析.中南大学学报(医学版), 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. 汤小东, 郭卫, 杨荣利, 等.肱骨近端肿瘤关节内切除假体置换术中应用人工韧带重建肩周软组织可提高肩关节功能.中华肩肘外科电子杂志, 2015, 3(2): 39-45.
14. 吴宏斌, 邵增务, 郑启新, 等.人工补片肩关节囊重建防治肿瘤型人工肱骨头假体脱位.临床骨科杂志, 2008, 11(5): 421-424.
15. 游木荣, 荆珏华, 于秀淳, 等.肱骨近端恶性肿瘤切除后骨缺损的重建.临床骨科杂志, 2010, 13(4): 387-390.
16. 陈勇, 宋金纲, 杨蕴, 等.恶性肿瘤关节置换中人工补片的作用.中国骨与关节杂志, 2010, 9(1): 24-28.
17. 万荣, 张伟滨, 徐建强, 等.定制型肱骨近端假体结合人工补片重建肩关节的疗效分析.中华骨科杂志, 2011, 31(6): 600-604.
18. 王永贵, 刘江涛.肿瘤假体置换在肱骨近端恶性骨肿瘤治疗中的应用.中国骨与关节杂志, 2014, 3(7): 511-515.
19. 郭卫, 孙馨, 燕太强, 等.保留上肢的肩胛带切除术治疗肩胛带恶性肿瘤.中华骨科杂志, 2011, 31(6): 587-593.
20. 史思峰, 董扬, 张春林, 等.人工肩关节假体置换治疗肱骨近端骨肿瘤.癌症, 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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