Advances in the treatment of sarcomas of the extremity. Current status of limb salvage.

Nonamputative limb salvage is possible for many patients with malignant skeletal or soft tissue sarcomas. Significant advances in pathology, radiology, chemotherapy, radiation therapy, and surgical and biomechanical techniques have contributed to a better understanding of these diseases, and have provided the necessary techniques to achieve local tumor control without amputation. Integration of diagnostic and treatment modalities has reduced local recurrence and improved overall patient survival. Preoperative (neoadjuvant) therapy permits assessment of the treatment effect and appears to significantly improve selection of effective postoperative adjuvant therapy. As overall patient survival has improved, efforts to increase local tumor control and to evaluate long-term functional stability of the salvaged extremity are now possible.