Title

Amputation for Recurrent Soft Tissue Sarcoma of the Extremity: Indications and Outcome

Publication Type

Journal Article

Publication Date

2001

Abstract

Limb salvage after primary site failure of extremity soft tissue sarcoma is a challenging problem. Amputation may be the most effective treatment option in selected patients with local recurrence. We compared the outcome of patients treated with amputation versus limb-sparing surgery (LSS) for locally recurrent extremity sarcoma. Methods: From 1982 to 2000, 1178 patients with localized primary extremity sarcoma underwent LSS. Of these, 204 (17%) developed local recurrence. Eighteen (9%) required major amputation and the remainder underwent LSS, of which 34 were selected for matched-pair analysis according to established prognostic variables. Rates of recurrence or death were estimated by the Kaplan-Meier method. Following adjustment for prognostic variables, a Mantel-Haenszel test was used to compare the outcome between the two treatment groups. Results: Patients in each group were well matched. All patients had high-grade tumors deep to the fascia. Median time to local recurrence was similar for both groups. Median follow-up was 95 months. Amputation was associated with a significant improvement in local control of disease (94% vs. 74%; P = .04). We observed no difference in disease-free ( P = .48), disease-specific ( P = .74), or overall survival ( P = .93) between the two groups. Median postrecurrence survival was 20 months and 5-year OS was 36% for the entire study group. Conclusions: Limb-sparing treatment achieves local control in the majority of recurrent extremity sarcomas for which amputation is infrequently indicated. Amputation improves local disease control but not survival under these circumstances.

Discipline

Econometrics | Medicine and Health Sciences

Research Areas

Econometrics

Publication

Annals of Surgical Oncology

Volume

8

Issue

6

First Page

509

Last Page

518

ISSN

1068-9265

Identifier

10.1007/s10434-001-0509-3

Publisher

Lippincott Wiliams and Wilkins

Additional URL

http://dx.doi.org/10.1007/s10434-001-0509-3

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