[Biopsy in sarcoma of the limbs. 135 cases]

Between 1979 and 1984, 135 patients with primary bone and soft tissue sarcoma of the limbs and girdles were treated conservatively, using a variety of methods. In 54 patients the biopsy was adapted to the requirements of one-block extratumoral resection; all remained with a functional limb and only suffered minima complications, viz. skin necrosis in 3 cases, resolved infection in 1 case and local recurrence in 2 cases, one of which was cured by a second conservative excision. Fifty-one patients were biopsied with a technique that was not adapted to a conservative anticancer treatment. In these patients the biopsy was most probably responsible for 4 therapeutic failures, 4 immediate amputations, 5 local recurrences, 6 out of 7 cases of skin necrosis and 2 out of 3 cases of deep infection consecutive to conservative surgery. The biopsy technique therefore is a determinant factor of local prognosis, more important than the size or location of the tumour or the presence of a fracture. Used routinely, without prior CT examination and disregarding precise rules, it is fraught with serious consequences and responsibilities.