An Epidemiological Study Analyzing Presentation and Oncological Outcome of Primary Malignant Tumors of Femur in Mohan Dai Oswal Cancer Hospital, Ludhiana, Punjab

Amputation was generally considered the standard treatment for most primary malignant tumors of femur. In recent years with the significant advances in the management of malignant bone tumors (better understanding of the histological criteria for diagnosis, better clinical staging procedure, improved surgical techniques, neo adjuvant & adjuvant chemotherapy and radiotherapy and improved techniques of Oncological reconstruction), there is increased trend towards limb salvage surgery.

1) To study presentation and oncological outcome of primary malignant tumors of Femur.

This study was a retrospective as well as prospective study involving 25 patients having primary malignant tumour of femur coming to department of Orthopaedics at Mohan Dai Oswal Cancer Treatment & Research Foundation, Ludhiana from January 1999 to December 2005.

All the patients were evaluated in terms of complete clinical presentation (onset of symptoms, progression and duration). Various signs and symptoms (pain, swelling, pathological fracture, deformity, limb length discrepancy) were noted thoroughly.

Treatment included Surgical management (Limb sparing surgery or amputation), Chemotherapy, Radiotherapy wherever indicated.

Once the decisions for surgery were taken, consent was taken from patient in written. If prosthesis is indicated, size of prosthesis was determined pre-operatively using x-ray and CT scan. Prosthesis was then ordered as required. Patients were followed for a minimum period of one year. These patients were called every month for the first 3 months and then every three monthly for next 9 months and 6 months thereafter. At each visit evaluation of these patients was done for:

Any signs of radiological/clinical union.

Any signs of local recurrence/distant metastasis.

Any implant/graft related problem.

25 patients of primary malignant tumours of femur were studied in the Department of Orthopaedics at Mohan Dai Oswal Cancer Hospital, Ludhiana from January 1999 to December 2005. Average age was 22.68 years. There were 21 male patients and 4 female patients. The major histopathological diagnosis was osteosarcoma (84%) followed by spindle cell sarcoma (8%) and chondrosarcoma (8%). Distal end of femur was predominantly involved (84%) and pain was the commonest presenting complaint (92%). Majority of patients (68%) presented after 60 days of onset of symptoms.