Amputation for Extremity Sarcoma: Contemporary Indications and Outcomes.

Area of Science:

• Orthopedic Oncology
• Surgical Oncology
• Sarcoma Research

Background:

• Amputation for extremity sarcoma (ES) was once standard but is now infrequent.
• This study examines reasons for and outcomes of amputation in contemporary ES cases.

Purpose of the Study:

• To determine indications for primary vs. delayed amputation in ES.
• To compare outcomes based on amputation timing.
• To evaluate survival in patients undergoing amputation for ES.

Main Methods:

• Retrospective review of 54 patients with primary, nonmetastatic ES undergoing amputation (2001-2011).
• Patients categorized into primary amputation (A1), secondary amputation (A2), and hand/foot sarcoma (HF) cohorts.
• Univariate analysis and survival calculations (DSS, MFS, OS).

Main Results:

• Indications for amputation varied by cohort, including loss of function, bone/joint involvement, tumor size, and neurovascular compromise.
• No significant difference in disease-specific survival (DSS) or metastasis-free survival (MFS) between primary (A1) and secondary (A2) amputation.
• Hand and foot sarcoma (HF) cohort demonstrated longer overall survival (OS) compared to A1/A2 cohorts.

Conclusions:

• Indications for amputation in ES are diverse and depend on amputation timing and tumor location.
• Judiciously performed amputations yield excellent disease control and survival.
• Amputation timing (early vs. delayed) does not influence survival for ES patients requiring limb loss.