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Musculoskeletal Cancer Surgery: A Comprehensive Review of Malawer's Approach

• Surgical techniques: Limb salvage, wide resection, amputation
• Anatomical regions: Pelvis, femur, humerus, spine, scapula
• Procedures: Rotationplasty, hemipelvectomy, claviculectomy, endoprosthetic reconstruction
• Illustrations: High-quality surgical diagrams, intraoperative photos, imaging correlations
• Clinical focus: Osteosarcoma, Ewing’s sarcoma, chondrosarcoma, soft tissue sarcomas
• Reconstruction: Megaprostheses, allografts, vascularized fibula grafts
• Complications & management: Wound healing, infection, local recurrence

• Chemotherapy: Standard for osteosarcoma (MAP regimen – methotrexate, doxorubicin, cisplatin) and Ewing sarcoma (VDC/IE).
• Radiation Therapy: Indicated for positive margins, radiosensitive histologies (e.g., Ewing, synovial), or when resection is limited.

The Malawer classification system guides treatment decisions and predicts surgical outcomes. The following sections outline treatment approaches for each Malawer classification type:

1. The Malawer Classification System