Malignant tumors of the shoulder girdle: Surgical and functional outcomes

Large resection and reconstruction of the malignant tumors of the shoulder girdle are used to provide maximum protection of the soft tissues with sufficient surgical margin. However, these have their own difficulties. The goals of this study were to review demographic data of 187 patients diagnosed with the malignant tumors located around shoulder between 2001 and 2016 in our clinic, to evaluate the functional outcomes and surgical outcomes, and to classify the resection methods according to new classification systems.

There were 187 patients (108 male and 79 female) and the mean age at surgery was 47.9 (range 2-87). Fifty-one of these patients underwent biopsy only: 8 partial/total claviculectomy, 10 partial/total scapulectomy, 80 proximal humeral resection, 5 total humeral resection, 6 shoulder girdle resection, and 13 amputations. Eighty-six had prosthetic implants, five had fibula transpositions, and one had a massive homologous bone graft. Seventy-one of the 136 patients were followed for an average of 40.3 months.

When the bone resections were evaluated, the best results were obtained while the rotator cuff function is preserved in glenoid preserving partial scapulectomy, partial/total claviculectomy, and proximal humerus intercalary resection. In total, scapulectomy and proximal/total humeral resection operations' results were moderate because of partial or total injury of the abductor mechanism.

As a result, malignant tumors of the shoulder girdle and soft tissue can be treated with limb-sparing surgery procedures. Reconstructive procedures and reconstructive methods such as prosthetic replacement, auto-allograft, and soft tissue reconstructions should be specified in each case. These resection and reconstruction methods are reliable and applicable procedures for local tumor control, pain control, and functional outcomes. More rarely, amputation/disarticulation can be performed.