Epithelioid sarcoma of the hand

Area of Science:

• Orthopedics
• Surgical Oncology
• Hand Surgery

Background:

• Epithelioid sarcoma of the hand is a rare and aggressive soft tissue tumor.
• Many patients present with a history of prior excisions and misdiagnoses, complicating initial treatment.
• Effective management requires a multidisciplinary approach focusing on complete tumor resection.

Purpose of the Study:

• To evaluate the effectiveness of preoperative imaging in diagnosing epithelioid sarcoma of the hand.
• To determine the role of adjuvant therapy in improving outcomes.
• To analyze survival rates and functional outcomes following various surgical resection strategies.

Main Methods:

• Retrospective review of 28 patients with primary epithelioid sarcoma of the hand.
• Analysis of surgical management including wide excision, partial hand amputation, and forearm amputation.
• Assessment of preoperative imaging, adjuvant therapies, and long-term follow-up data.

Main Results:

• Aggressive surgical management with negative margins achieved disease-free status in 71% of patients.
• Five- and 10-year survivorship rates were 85%.
• Treatment failures included local recurrence, regional metastases, and distant metastases, with 5 disease-related deaths.

Conclusions:

• Complete surgical resection with negative margins is critical for favorable outcomes in epithelioid sarcoma of the hand.
• Adjuvant therapies and preoperative imaging play roles in optimizing treatment and should be further investigated.
• Despite challenges, aggressive surgical intervention offers a significant chance for long-term survival and disease control.