Case series. Soft-tissue sarcoma of the foot

Area of Science:

• Orthopedic Oncology
• Surgical Oncology
• Sarcoma Research

Background:

• Soft-tissue sarcoma of the foot is a rare condition.
• Understanding its presentation, treatment, and outcomes is crucial.
• Evaluating limb-salvage surgery effectiveness is important for patient care.

Purpose of the Study:

• To investigate the presentation, treatment, and outcomes of soft-tissue sarcoma of the foot.
• To determine if limb-salvage surgery provides acceptable functional and oncological results.

Main Methods:

• Retrospective review of 16 patients with soft-tissue sarcoma of the foot over 15 years.
• Data extraction included disease status, prior treatment, histology, AJCC stage, treatment details, and outcomes.
• Functional outcomes assessed using the Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (MSTS 1987) scores.

Main Results:

• Synovial sarcoma was the most common diagnosis (7/16 patients).
• Most patients (13/16) had AJCC stage II or III disease.
• Limb salvage was achieved in 13 patients, often requiring free tissue transfer (9) and radiation therapy (12).
• Local recurrence occurred in 2 patients, and lung metastases in 4.
• Functional outcomes were good, with MSTS 1987 averaging 28% and TESS averaging 90% after limb salvage.

Conclusions:

• Unplanned excisions prior to presentation may negatively impact oncological outcomes.
• Limb salvage is feasible but often involves marginal resections, necessitating adjuvant therapies.
• The combination of limb salvage, free tissue transfer, and radiation therapy provides acceptable local control and excellent functional results.