The interscapulothoracic amputation in the treatment of malignant diseases of the upper extremity with a review of the literature.

The majority of patients with soft tissue sarcoma (STS) or bone sarcomas (BS) of the upper limb can be treated today with limb saving procedures using combined modality therapies. However, for a small group of patients the interscapulothoracic (IST) amputation is the only final surgical treatment with either a curative or a palliative intent. Since 1972, 12 patients seven males and five females, median age 36 years (range 13-82) underwent an interscapulothoracic amputation; five for bone sarcomas, five for soft tissue sarcoma and two for locoregional metastases. There was no post-operative mortality or morbidity. During a median follow-up of 8 years (range 0.25-15), there was no local recurrence. The five-year survival rate for the soft tissue sarcomas was 80% and for the bone sarcomas 30%. The interscapulothoracic amputation is one of the major ablative surgical procedures which should be performed with curative intent, very rarely with a low palliative intent. The prognosis of an interscapulothoracic amputation for shoulder girdle malignancies is not different from extremity soft tissue sarcomas or bone sarcomas located more distally. The morbidity and local recurrence rate after interscapulothoracic amputation should be negligible.