Complications and functional results after limb-salvage surgery and radiotherapy for difficult mesenchymal neoplasms: a prospective analysis.

Wide resection with adjuvant radiotherapy is generally accepted as the optimal treatment for patients with extremity soft-tissue sarcomas. However, there is a subset of patients with "difficult" tumours who sustain such marked loss of function from limb-salvage procedures that amputation might offer a superior functional alternative. To evaluate this issue, the authors prospectively designated 19 of 52 patients registered in Toronto's Princess Margaret Hospital Prospective Sarcoma Database in 1986 as "difficult" cases, on the basis of tumour size and anatomical location. Complications and functional results of wide resection and adjuvant radiotherapy were documented. The most frequent complication was related to wound healing (8 of 19 patients). Functional analysis at 1 year follow-up demonstrated that all 19 patients had results superior to those that would be expected with amputation.