Limb preserving surgery for soft-tissue sarcoma in the hand: a retrospective study of 51 cases

Abstract

Our retrospective study analysed the long-term results of a conservative limb-preserving surgical strategy in 51 patients with soft-tissue sarcoma of the hand from a single institution. We assessed survival and prognostic factors, including the surgical margins. No transradial amputations were performed. Microscopically free resection margins were obtained in 45 of the patients. The remaining six patients had microscopically incomplete resection. Forty-four surviving patients had a median follow-up of 6.5 years (range 12–307), and one patient had no follow-up beyond 3 months following surgery. Among those patients, 29 had more than 5 years of follow-up. Five-year local-recurrence-free survival was 65%, metastasis-free survival was 84%, and disease-specific survival was 91%. Tumour size was predictive of all outcome parameters, but positive resection margins adversely affected local recurrence only. Survival was similar to the survival after a more radical surgical approach reported in the literature. Level of evidence: IV

Interdisciplinary Surgical Therapy of Extremity Soft-Tissue Sarcomas: A Personalized Resection and Reconstruction Algorithm

“…Historically, the amputation of the extremity was state of the art in the treatment of sarcomas of the upper and lower extremities. Through the years, it was shown that the amputation of the extremity is not advantageous regarding long-term survival compared to R0 resection [ 22 , 23 , 24 ]. Important is the so-called wide resection in the healthy tissue surrounding the tumor with tumor free margins [ 25 , 26 ].…”