TAILIEUCHUNG - Phẫu thuật điều trị bệnh di căn xương đùi

Gần như tất cả các khối u ác tính đã được mô tả là có khả năng di căn vào xương. Trong số ước tính 1,2 triệu trường hợp mới của bệnh ung thư được chẩn đoán hàng năm, hơn 50% cuối cùng sẽ chứng minh di căn xương. Những tiến bộ trong điều trị và xạ trị hệ thống đã dẫn đến một sự cải thiện đáng kể | Surgical Treatment of Metastatic Disease of the Femur Kyle C. Swanson MD Douglas J. Pritchard MD and Franklin H. Sim MD Abstract Nearly every malignant neoplasm has been described as having the capability to metastasize to bone. Of the estimated million new cases of cancer diagnosed annually more than 50 will eventually demonstrate skeletal metastasis. Advances in systemic and radiation therapy have led to a considerable improvement in the prognosis of patients with metastatic disease. As a result orthopaedic surgeons are being asked with increasing frequency to evaluate and treat the manifestations of skeletal metastases. The femur is commonly the site of large impending lesions and complete pathologic fractures. Although the health status of some patients may preclude operative intervention established pathologic fractures of the femur and metastatic lesions deemed likely to progress to imminent fracture generally should be treated surgically. A rational approach to selection of the proper treatment for these problems includes consideration of the patientÕs overall medical condition and the type location size and extent of the tumor. Treatment principles are the same regardless of location. A construct should ideally provide enough stability to allow immediate full weight bearing with enough durability to last the patient s expected lifetime. All areas of weakened bone should be addressed at the time of surgery in anticipation of disease progression. To minimize disease progression and possible implant or internal fixation failure postoperative external-beam irradiation should be considered. J Am Acad Orthop Surg 2000 8 56-65 Metastatic disease is the leading cause of death in cancer patients. Bone is the third most common site of metastatic disease after lung and liver. Tumors of breast thyroid lung prostate and kidney origin are the most likely to metastasize to bone. Of the estimated million new cases of cancer diagnosed more than one half will be .

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