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Functional and clinical outcomes of limb-sparing therapy for pediatric extremity sarcomas
C S Bertucio1, W M Wara, K K Matthay
1Department of Radiation Oncology, University of California-San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0226, USA.
Insights
Limb-sparing therapy for pediatric extremity sarcomas preserves limb function in 90% of patients. This approach demonstrates validity in maintaining excellent or good limb function without compromising survival rates.
Area of Science:
- Pediatric Oncology
- Orthopedic Oncology
- Radiation Oncology
Background:
- Extremity sarcomas are rare but aggressive childhood cancers.
- Limb-sparing surgery aims to remove tumors while preserving the affected limb.
- External beam radiotherapy is a key component in multidisciplinary treatment protocols.
Purpose of the Study:
- To evaluate clinical and functional outcomes in children with extremity sarcomas treated with limb-sparing therapy.
- To assess the efficacy of limb preservation in this pediatric population.
Main Methods:
- Retrospective review of 30 pediatric patients (< or = 21 years) treated between 1979-1998.
- Inclusion criteria: primary extremity sarcomas, limb-sparing therapy including external beam radiotherapy, and complete follow-up data.
- Outcome measures: patterns of failure, overall survival, disease-free survival, local control, and limb function.
Main Results:
- Median follow-up was 3 years.
- 12 of 30 patients experienced recurrence (3 local, 8 distant, 1 synchronous).
- 18 patients were alive with no evidence of disease; median overall survival was 10 years, median disease-free survival was 8 years.
- Functional limb assessment: 15 excellent, 12 good, 1 fair, 2 poor.
Conclusions:
- Limb-sparing therapy resulted in 90% of pediatric patients maintaining excellent or good limb function.
- The findings support the validity and effectiveness of limb preservation in managing pediatric extremity sarcomas.
- This approach balances oncologic control with functional preservation in young patients.
Purpose:
To determine the clinical and functional outcomes of children undergoing limb-sparing therapy for extremity sarcomas.
Methods And Materials:
We retrospectively reviewed 30 patients, age < or = 21 years, who were treated between l979 and l998 with external beam radiotherapy as a component of limb-sparing therapy for primary sarcomas of the extremity at UCSF. Included were patients for whom complete follow-up and functional outcome assessments were available. We assessed the patterns of failure, overall survival, disease-free survival, local control, and limb function.
Results:
At a median follow-up of 3 years, 12 of the 30 patients recurred: 3 locally, 8 distantly, and 1 with synchronous local and distant disease as site of first progression. Eighteen patients were alive with no evidence of disease. The median overall survival was 10 years, with a median disease-free survival of 8 years. Functional outcome assessment revealed 15 patients retained excellent, 12 good, 1 fair, and 2 poor limb function.
Conclusion:
In pediatric patients receiving limb-sparing therapy, 90% maintained excellent or good limb function without compromising survival, demonstrating the validity of limb preservation in children with extremity sarcomas.
