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Outcomes in patients with popliteal sarcomas
Robert E Turcotte1, Marco Ferrone, Marc H Isler
1McGill University Health Centre, Montréal, Que. robert.turcotte@muhc.mcgill.ca
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|February 24, 2009
Summary
Popliteal fossa soft-tissue sarcomas are challenging. Limb salvage surgery offers good function with a low local recurrence rate, even with positive margins, but adjuvant therapy is often needed.
Area of Science:
- Orthopedic Oncology
- Surgical Oncology
- Musculoskeletal Tumors
Background:
- Popliteal fossa soft-tissue sarcomas present significant surgical challenges.
- Achieving wide margins for limb salvage is difficult, often necessitating adjuvant therapies.
- Limb function can be compromised, impacting patient outcomes.
Purpose of the Study:
- To review the oncologic and functional outcomes of treating soft-tissue sarcomas in the popliteal fossa.
- To assess complications associated with various treatment modalities.
- To evaluate the efficacy of limb salvage versus amputation.
Main Methods:
- A prospective review of patients with popliteal sarcomas treated between 1994 and 2005.
- Inclusion criteria: patients treated at McGill University Health Centre and Maisonneuve-Rosemont Hospital.
- Data collected: oncologic outcomes, functional scores, and complications.
Main Results:
- 18 patients (12 women, 6 men; mean age 54) were analyzed.
- Common diagnoses: liposarcoma (6), synovial sarcoma (4), leiomyosarcoma (3).
- Limb salvage was performed in 15 patients; 11 had microscopically positive margins, yet local recurrence was 7%. Metastases occurred in 20% of limb salvage patients without local recurrence. Functional scores were good to excellent.
Conclusions:
- Despite a high rate of positive margins, limb salvage for popliteal fossa sarcomas yields a low local recurrence rate (7%).
- Amputation did not demonstrate a survival advantage.
- Limb-sparing surgery resulted in good to excellent functional outcomes for most patients.
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