A Clinicopathological Analysis and Functional Outcomes of Claviculectomy in Primary Malignant Tumours of Clavicle

Abstract

Introduction: Primary malignant tumours of the clavicle are exceptionally uncommon. In the literature the number of publications reporting long-term oncologic outcomes after claviculectomy is quite low. Aim: To analyse clinicopathological presentation of functional results of 15 patients with primary malignant clavicular tumour after claviculectomy and also to evaluate relationship of resection amount and the postoperative complication state with functional results. Materials and Methods: Fifteen patients (9 males, 6 females; mean age 44.8 years; range 2-87 years) with primary malignant tumours of clavicle who were performed claviculectomy between 2002 and 2017 were included the study. Patient’s mean follow-up duration was 41 months (range 14 to 68 months). Twelve patients underwent partial and 1 patient underwent total clavicle resection without reconstruction. Two patients underwent reconstruction with allograft fibula after partial clavicle resection. The functional result was assessed with the Constant-Murley scores, International Society of Limb SalvageMusculoskeletal Tumour Society (MSTS) evaluation system and The University of California-Los Angeles (UCLA) shoulder rating scale. Mann Whitney u test was used for comparison of data sets. Spearman correlation was used to test the association between resection amount and patient’s scale scores. Linear regression analyses were carried out to evaluate the association of resection amount with patient’s scale scores. Results: The mean postoperative MSTS score was 63.1±14.1 (range, 33-80), the mean Constant-Murley score was 57.8±13.7 (range, 30-74) and the mean UCLA score was 20.8±6.8 (range, 8-31). A statistically significant and perfect negative corelation was found between resection amount and MSTS score (r=-0.907 p<0.001), Constant-Murley score (r=-0.910, p<0.001) and UCLA score (r=-0.975, p<0.001). It has been found that resection amount was significantly higher in the patients with complication than in the patients without complication (p=0.005), and MSTS score (p=0.014), Constant-Murley score (p=0.026) and UCLA score (p=0.007) were significantly lower. Conclusion: The present study concluded that the extent of claviculectomy resection has an effect on shoulder functions. Although the shoulder functional scores were found to be ow, patient’s daily activities were affected minimally. Beside, reconstruction has not been suggested due to the high rates of complications.

Keywords

• bone tumour
• clavicle bone
• malignant neoplasms
• results
• surgery