Iliac vein occlusion prior to amputation for sarcoma

Abstract

Amputation of a limb has been the treatment of choice for osteogenic sarcoma of bone for the past 50 years with little change in the 5%‐10% 5‐year survival rate. Preoperative radiation therapy and amputation between tourniquets has not altered the survival rates in our area. In the State of Connecticut, 75% of the cases have died of pulmonary metastases within one year. This suggests that bloodstream metastases are extremely important. We have been doing preliminary laparotomies prior to amputation in bone sarcoma to determine evidence of intra‐abdominal spread to the liver or periaortic nodes. Common iliac vessels and femoral vessels are tied off to prevent dissemination of the cancer prior to manipulation for ampuatation of the extremity.