Amputation for recurrent soft tissue sarcoma of the extremity: Indications and outcome Journal Article
| Authors: | Stojadinovic, A.; Jaques, D. P.; Leung, D. H. Y.; Healey, J. H.; Brennan, M. F. |
| Article Title: | Amputation for recurrent soft tissue sarcoma of the extremity: Indications and outcome |
| Abstract: | Background: 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. |
| Keywords: | cancer survival; controlled study; treatment outcome; disease-free survival; limb salvage; surgical technique; survival rate; major clinical study; mortality; cancer localization; cancer recurrence; treatment planning; follow up; cancer grading; prospective studies; disease association; metastasis; neoplasm recurrence, local; sarcoma; limb; amputation; soft tissue sarcoma; extremities; disease control; matched-pair analysis; limb amputation; recurrent; extremity; fascia; humans; prognosis; human; male; female; article |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 8 |
| Issue: | 6 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2001-07-01 |
| Start Page: | 509 |
| End Page: | 518 |
| Language: | English |
| DOI: | 10.1007/s10434-001-0509-3 |
| PUBMED: | 11456050 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 21 May 2015 -- Source: Scopus |
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