Oncologic and functional outcomes of soft tissue sarcomas of the distal upper extremity: comparison with those of the proximal upper extremity.

To determine the factors predicting the oncologic and functional outcomes in patients with distal upper extremity soft tissue sarcomas, and to compare functional outcomes with those occurring in the proximal upper extremity, 28 consecutive patients with a soft tissue sarcoma in a distal upper extremity (group I) and 20 patients with one in a proximal upper extremity (group II) were surgically treated. The 5-year survival rate in patients with soft tissue sarcomas at distal and proximal locations were 74% and 87% for local recurrence, 84% and 66% for metastasis free, and 89% and 66% for overall, respectively. A significant adverse prognostic factor for local recurrence was deep location (P < 0.01). For metastasis-free and overall survival, adjuvant therapy (P < 0.001) and high-grade malignancy (P < 0.01) were significant poor prognostic factors. Deep location (P = 0.02) and prereferral surgery (P = 0.02) correlated with poorer function as reflected in the Musculoskeletal Tumor Society (MSTS) and Disabilities of the Arm, Shoulder, and Hand (DASH) functional scores, respectively. Patients in groups I and II showed good oncologic and functional outcomes. In group I patients, high-grade malignancy, adjuvant chemotherapy, and deep location were poor oncologic factors, and deep location and prereferral surgery were adverse prognostic factors for functional score.