M A Clark1, J M Thomas. 1. Melanoma and Sarcoma Unit, Royal Marsden Hospital, Fulham Road, Chelsea, London SW3 6JJ, UK.
Abstract
BACKGROUND: Advances in oncological practice have reduced the number of major amputations performed for soft-tissue sarcoma, but this remains a valuable, if infrequent, option for both curative and palliative indications. METHODS: A review of patients and case-notes was carried out from the prospective sarcoma database at the Royal Marsden Hospital. RESULTS: Over a 10-year interval, 40 major amputations (18 forequarter, 17 hindquarter and five through hip) were performed, predominantly for disease recurring after previous limb-conserving surgery (31 of 40). A wide variety of soft-tissue sarcoma subtypes was seen; they were often large (more than 10 cm; 18 of 40) or multifocal (six), usually high grade (25), and frequently proximal or involving neurovascular structures such that limb salvage was precluded. Median range age of the patients was 59 (17-87) years. The operative 30-day mortality rate was zero. Hospital stay was a median of 10.5 days for forequarter amputation, and 19 days for hindquarter and through-hip amputation. Local recurrence occurred in ten patients, six of whom had concurrent distant metastases. Twenty-seven patients were alive (20 disease free) at a median follow-up of 12 months, nine of whom were alive without evidence of disease beyond 2 years. Ten patients died after a median of 7.5 months; three survived more than 2 years. CONCLUSION: Major amputation is a useful procedure in carefully selected patients with soft-tissue sarcoma. Copyright 2002 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd
BACKGROUND: Advances in oncological practice have reduced the number of major amputations performed for soft-tissue sarcoma, but this remains a valuable, if infrequent, option for both curative and palliative indications. METHODS: A review of patients and case-notes was carried out from the prospective sarcoma database at the Royal Marsden Hospital. RESULTS: Over a 10-year interval, 40 major amputations (18 forequarter, 17 hindquarter and five through hip) were performed, predominantly for disease recurring after previous limb-conserving surgery (31 of 40). A wide variety of soft-tissue sarcoma subtypes was seen; they were often large (more than 10 cm; 18 of 40) or multifocal (six), usually high grade (25), and frequently proximal or involving neurovascular structures such that limb salvage was precluded. Median range age of the patients was 59 (17-87) years. The operative 30-day mortality rate was zero. Hospital stay was a median of 10.5 days for forequarter amputation, and 19 days for hindquarter and through-hip amputation. Local recurrence occurred in ten patients, six of whom had concurrent distant metastases. Twenty-seven patients were alive (20 disease free) at a median follow-up of 12 months, nine of whom were alive without evidence of disease beyond 2 years. Ten patients died after a median of 7.5 months; three survived more than 2 years. CONCLUSION: Major amputation is a useful procedure in carefully selected patients with soft-tissue sarcoma. Copyright 2002 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd
Authors: Colin M Parsons; Jose M Pimiento; David Cheong; Suroosh S Marzban; Ricardo J Gonzalez; David Johnson; G Douglas Letson; Jonathan S Zager Journal: J Surg Oncol Date: 2011-08-11 Impact factor: 3.454
Authors: John H Alexander; Sumanas W Jordan; Julie M West; Amy Compston; Jennifer Fugitt; J Byers Bowen; Gregory A Dumanian; Raphael Pollock; Joel L Mayerson; Thomas J Scharschmidt; Ian L Valerio Journal: J Surg Oncol Date: 2019-06-13 Impact factor: 3.454