Prognostic factors and surgical approaches for long bone sarcomas: a comprehensive narrative study

This study aimed to evaluate the outcomes of various surgical interventions for bone sarcoma, focusing on survival rates, functional outcomes, complication rates, and quality of life. A systematic review and analysis were conducted on six primary surgical interventions, including limb salvage surgery, wide resection, amputation, endoprosthetic reconstruction, biological reconstruction, and rotationplasty. Limb salvage surgery demonstrated the highest functional outcomes (85%) and quality of life scores (8.0/10), while endoprosthetic reconstruction achieved the highest survival rate (75%) but with a higher complication rate (30%). Amputation, despite the lowest complication rate (15%), showed reduced functional scores (65%) and survival rates (55%). Recovery times varied significantly, with biological reconstruction requiring the longest rehabilitation period (16 weeks) and wide resection the shortest (8 weeks). Psychological challenges were notable in amputation cases, with 15% of patients experiencing psychological issues. In conclusion: Limb-sparing procedures, where feasible, offer superior functional and quality-of-life outcomes compared to amputation, though they carry higher complication risks. The choice of surgical intervention should be individualized, balancing oncological and functional considerations. Future research should focus on reducing complication rates, improving prosthetic designs, and standardizing rehabilitation protocols to enhance patient outcomes. Long bone sarcomas, a rare and aggressive group of malignancies, primarily affect the skeletal system and pose significant challenges in clinical oncology. These tumors, which include osteosarcoma, Ewing sarcoma, and chondrosarcoma, are most commonly diagnosed in children, adolescents, and young adults, often leading to substantial morbidity and mortality. Despite advancements in diagnostic imaging, surgical techniques, and systemic therapies, the prognosis for patients with long bone sarcomas remains variable and is influenced by a multitude of factors.