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Soft-tissue sarcomas of the proximal lower extremity
C P Karakousis1, L J Emrich, D S Vesper
1Department of Surgical Oncology, Roswell Park Memorial Institute, Buffalo, NY 14263.
Archives of Surgery (Chicago, Ill. : 1960)
|November 1, 1989
Summary
Limb-preserving surgery for proximal lower extremity soft-tissue sarcomas achieved a high limb salvage rate. This approach resulted in a 65% 5-year disease-free survival with low local recurrence, demonstrating its effectiveness.
Area of Science:
- Orthopedic Oncology
- Surgical Oncology
- Musculoskeletal Tumors
Background:
- Soft-tissue sarcomas of the proximal lower extremity are challenging tumors.
- Limb salvage is preferred over amputation when feasible to maintain function.
Purpose of the Study:
- To evaluate the outcomes of limb-preserving resection for proximal lower extremity soft-tissue sarcomas.
- To assess limb salvage rates, functional outcomes, and oncologic control in these patients.
Main Methods:
- Retrospective review of 54 patients with proximal lower extremity soft-tissue sarcomas.
- Analysis of treatment modalities including limb-preserving resection and adjuvant radiotherapy.
- Evaluation of limb salvage, local recurrence, and disease-free survival rates.
Main Results:
- 96% of patients underwent limb-preserving resection; only 4% had amputation.
- Adjuvant radiotherapy was used selectively in 22 patients with margins < 2 cm.
- A 5-year disease-free survival rate of 65% was observed, with a local recurrence rate of 6% at a median follow-up of 30 months.
Conclusions:
- Limb-preserving resection is a highly effective strategy for proximal lower extremity soft-tissue sarcomas.
- Technical advancements facilitate successful limb salvage with satisfactory function.
- Selective adjuvant radiotherapy can be employed to optimize oncologic outcomes.