Affiliation:
1. Melanoma and Sarcoma Unit, Royal Marsden Hospital, Fulham Road, Chelsea, London SW3 6JJ, UK
Abstract
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.
Publisher
Oxford University Press (OUP)
Cited by
40 articles.
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