The Indications for and the Prognostic Significance of Amputation as the Primary Surgical Procedure for Localized Soft Tissue Sarcoma of the Extremity

Abstract

The decision to perform a primary amputation for an STS of the extremity is based on the location and local extent of the tumor, and the expected function of the extremity after tumor resection. The higher risk of metastases for patients who require primary amputation is accounted for by independent risk factors associated with their tumors--predominantly large tumor size.

Local Recurrence After Initial Multidisciplinary Management of Soft Tissue Sarcoma: Is there a Way Out?

“…Little is known about the interplay of local recurrence and distant metastases, and it remains unclear what real impact local recurrences have on the overall survival of soft tissue sarcoma patients. It could be argued a second attempt to eradicate disease locally should be at least, if not more, aggressive than the first and thus historically amputation was favored [3,23], but amputation does not prevent the occurrence of metastases [8] and death. More recently, repeated attempt at limb salvage has become a reasonable option for many of these patients.…”

Segmental Resection and Replantation Have a Role for Selected Advanced Sarcomas in the Upper Limb

“…However, amputation has been advocated for selective cases of primary sarcoma of the upper extremity when they are large or extensive or when they have neurovascular involvement, local tumor contamination after unplanned surgery, or pathologic fracture [10,18,21] of Stage IIB or III [7].…”

The role of plastic surgery in sarcoma treatment

“…The index of primary amputations was 5.3%. This percentage of primary amputations is within the usual range of the large series of limb sarcomas as well as that of Ghert et al, with 6% of primary amputations in 413 patients [17]. There were 13 (13.9%) cases of local recurrences in extremities; this signifi es a local recurrence rate somewhat below those reported in the large series, which range from 20% in the Rosenberg series of 1982 to [18,19].…”