Nicolas de l'Escalopier1,2, Laurent Mathieu3,4, Philippe Anract5, David Biau5. 1. Clinic of Orthopedics, Traumatology and Reconstructive Surgery, Percy Military Teaching Hospital, 92140, Clamart, France. ndelescalopier@gmail.com. 2. Orthopedic Department, Cochin Hospital, AP-HP, 75014, Paris, France. ndelescalopier@gmail.com. 3. Clinic of Orthopedics, Traumatology and Reconstructive Surgery, Percy Military Teaching Hospital, 92140, Clamart, France. 4. French Military Health Service Academy, Ecole du Val-de-Grâce, 75005, Paris, France. 5. Orthopedic Department, Cochin Hospital, AP-HP, 75014, Paris, France.
Abstract
BACKGROUND: Management of extremity tumor is particularly challenging in low-resource settings where patients are often referred with late presentations. First, diagnostic means are limited, with CT scan, MRI, and pathology usually not being available. Limitations are also related to therapeutic means, as the absence of adjuvant therapy (chemotherapy and radiotherapy) may preclude any improvement in overall survival despite a curative surgical treatment. OBJECTIVE: The authors suggest a kind of "toolbox" combining a diagnostic guide, based on clinical examination and X-rays, and therapeutic advice adapted to this context of care. The objective is to help the surgeon to better categorize the tumor to decide whether or not to operate or act in a relevant way. CONCLUSION: The authors do not aim to provide recommendations but rather an inventory of what the isolated surgeon should know to decide on the best treatment strategy which, however, can only be symptomatic.
BACKGROUND: Management of extremity tumor is particularly challenging in low-resource settings where patients are often referred with late presentations. First, diagnostic means are limited, with CT scan, MRI, and pathology usually not being available. Limitations are also related to therapeutic means, as the absence of adjuvant therapy (chemotherapy and radiotherapy) may preclude any improvement in overall survival despite a curative surgical treatment. OBJECTIVE: The authors suggest a kind of "toolbox" combining a diagnostic guide, based on clinical examination and X-rays, and therapeutic advice adapted to this context of care. The objective is to help the surgeon to better categorize the tumor to decide whether or not to operate or act in a relevant way. CONCLUSION: The authors do not aim to provide recommendations but rather an inventory of what the isolated surgeon should know to decide on the best treatment strategy which, however, can only be symptomatic.
Authors: Santiago A Lozano Calderón; Kevin A Raskin; Francis Hornicek; Joseph H Schwab Journal: J Bone Joint Surg Am Date: 2015-12-16 Impact factor: 5.284
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