Introduction of new diagnostic methods including various imaging techniques in the field of orthopaedic surgery has enabled us to make early and precise diagnoses of musculoskeletal tumors. In addition, recent progress in the chemotherapy and radiotherapy of malignant tumors has raised the five-year survival rate remarkably, although complete recovery from these treatments alone cannot be expected as yet. These medical advances naturally stimulate the search for ways of limb salvage even in malignant musculoskeletal oncology. To this pur pose, not only oncologists, but orthopaedic surgeons, radiologists, engineers, and biomaterials scientists should work together to design suitable surgical procedures and prostheses using autograft, allograft and biomaterials. The First International Workshop on the Design and Application of Tumor Prostheses for Bone and Joint Reconstruction was held in 1981 in Rochester, Minnesota. Participants were of an interdisciplinary nature in order to establish a basis for cooperative efforts, which have subsequently spread throughout the world. Since then, biennial inter national symposia have been held successively in Vienna, Florida, and Kyoto. Previous gatherings of this prestigious series were open only to a small number of experts.

This book gives information about the newest methods for limb salvage in musculoskeletal oncology. The contributions describe concepts of chemotherapy, immunotherapy, radiation therapy, hyperthermia, and biomechanical and biomaterial design for the fabrication of tumor prosthesis. Functional results in terms of limb salvage are evaluated by an internationally accepted rating system. Various modern approaches to limb salvage for malignant musculoskeletal conditions are given.

Based on ten years of experience, this book provides a valuable tool for professionals in the field of bone tumors. Although rare, when diagnosed these tumors can cause anxiety and apprehension in patients, and it is necessary to find rapid solutions and medical rehabilitation protocols capable of dealing with these delicate cases. As such those working in this field need to constantly update their knowledge to ensure an appropriate approach to this particular pathology. This book is a useful consultation tool for physiotherapists, orthopedic oncology surgeons, rehabilitation specialists and everyone who works with bone tumors on a regular basis.

Recent advances in diagnostic technology, including imaging, gene analysis and histopathology, form one cornerstone of this update for health care specialists treating patients with musculoskeletal cancer. The other cornerstone consists of chemotherapy and radiotherapy, as well as highlights in surgical treatment and rehabilitation. The complete structure conveys a systematic understanding of musculoskeletal oncology, with sections on limb saving procedures, reconstruction methods of bone and soft tissues, tumor prosthesis and spinal reconstruction in metastatic bone tumors. All the information is placed under the encompassing goal of total care for the patient.

An international group ofresearchers has met every 2 years since 1981 to examine the progress made in limb salvage techniques and the perspectives of this field of surgery. In 1989 the Fifth International Symposium On Limb Salvage (ISOLS) was held in Saint Malo and was attended by more than 300 participants from 34 different countries. The 105 papers presented, grouped under eleven main headings, have been included in this book. Limb salvage has indeed progressed in the years since the first symposium. Initially it essentially concerned tumours and the main aim was to salvage the diseased limb through non-mutilating surgery without jeopardizing the patient's prospects of survival. Now, with a confirmed high rate of 5-year disease-free survival, new goals can be set: improvement of the functional results and of the survival of our reconstructions. How can this be achieved: - By favouring muscle reattachment on the prosthesis, for instance through the use of a bone allograft-sleeved composite prosthesis? - By improving the survival of the arthroplasty through the develop ment of a more biological fixation of its stems? - By limiting the side effects of the necessary adjuvant treatments on the function of the allograft as well as on the fixation of the prosthesis? In addition, limb salvage procedures now concern not only primary tumours (and metastases, which must be treated using the same osteosynthetic and prosthetic techniques), but also reconstructive orthopaedic surgery as a whole.

Steven A. Rosenberg, MD In the past two decades significant progress has quality of life. The use of local radiation therapy has occurred, in the management of patients with mus- had a profound impact on the ability to achieve local loskeletal cancers, that has improved both the survival control. Cooperation between surgeons and radiation and the quality of life of afflicted patients. Changes in therapists often results in the tailoring of surgical p- the management of these patients have mirrored cedures to maximize the combined application of these trends in the entire field of oncology. two effective treatment modalities. Although impact on The most significant change has been improvement overall survival has not been demonstrated due to the in the surgical techniques for the resection of musculo- addition of radiation therapy, important advances in skeletal cancers based on a detailed understanding of improving the quality of life of patients receiving this the anatomic features of each particular tumor site, as combined-modality treatment have been evident. well as an appreciation of the natural biology that affects A third change impacting on the survival of patients the local spread of these tumors. The current volume of with musculoskeletal cancers has been the aggressive Musculoskeletal Cancer Surgery: Treatment of Sarcomas and resection of metastatic deposits.

Leading orthopaedic surgeons and other specialists collaborated to provide this multi-disciplinary perspective on musculoskeletal tumors. Through their eyes and insights, you will gain a big picture view of the latest innovations in tumor care and optimized treatment. Explore leading-edge research and clinical innovations in pathology, radiology and emerging treatments—in a single, concise volume.