転移性骨腫瘍に対する大腿骨腫瘍用人工骨頭置換術の治療成績

Clinical Results of Modular Prostheses for Metastatic Bone Tumor of Proximal Femur

　大腿骨近位部転移性骨腫瘍患者で2000～2007年の間に当院で腫瘍用人工骨頭置換術を施行した14例の手術成績を検討しその適応を考察した．原発巣は乳癌4例，肺癌3例，大腸癌2例，腎癌2例，食道癌1例，胃癌1例，直腸癌1例であった．経過観察中全例で局所再発を認めなかった．1年生存率は64.3％で，術後9例が片松葉杖以上の歩行能を獲得できた．本術式は，症例を選べば大腿骨近位部転移性骨腫瘍で病的骨折を起こした患者や局所制御が困難な患者に有用であり，積極的に考慮すべきと考えられる．

　From 2000 to 2007, 14 patients with metastatic bone disease of the proximal femur were treated by resection of the lesion and insertion of a modular prosthesis.　The tumors included 4 breast carcinoma, 3 lung carcinoma, 2 colon carcinoma, 2 renal cell carcinoma, 1 esophageal carcinoma, 1 gastric carcinoma, 1 rectal carcinoma.　At latest review (at an average 19.2 months after the operation, range 1 to 90 months) no patients presented local recurrence.　In this series, satisfactory functional and oncologic results were achieved with few complications.　Modular prosthetic replacement contributes to an improved quality of life and limb functionality and could be indicated also in patients with limited life expectancy.