Grimer, Robert John (2011)
D.Sc. thesis, University of Birmingham.
This thesis summarises the author’s lifelong work to improve outcomes for patients with musculoskeletal tumours. It starts with analysing diagnostic features and steps that could be taken to improve the time to diagnosis of these rare tumours. It continues with a number of basic science projects which the author has either carried out or collaborated with. Benign bone tumours are common in children and are discussed. The author has probably one of the largest personal experiences of treating primary malignant bone and soft tissue tumours and this is evidenced by the papers on osteosarcoma, chondrosarcoma, Ewing’s sarcoma and soft tissue sarcoma. The indications for and outcomes of major ablative amputations are outlined followed by an extensive review of the outcomes of limb salvage surgery with endoprostheses and other techniques. The role of this type of surgery in metastatic disease is put in context. Finally the importance of follow up and guidelines is considered. The thesis represents an analysis of the huge improvements that have taken place in the past 25 years in musculoskeletal oncology but also reveals the many still unanswered questions in this evolving field.
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