[Surgical treatment for bone and soft tissue sarcomas of the shoulder part]

Since 1977 we have treated 18 bone sarcomas and 16 soft tissue sarcomas of the shoulder part. For 10 bone sarcomas of the proximal humerus, four fore-quarter amputations, two curative wide resections, and four wide excisions were performed as radical operations. The reconstructive procedures after the six resections were two spacer insertions, one total shoulder replacement, and three arthrodeses with autografts. Considering the functional result, the arthrodesis is the most-recommended method. For eight bone sarcomas of the scapula, three total resections and four partial resections of the scapula, and one debulking operation were performed. For 16 soft tissue sarcomas, we performed two ablative operations, three curative wide resections, five wide excisions, and six conservative operations after adjunctive chemo-and/or radiotherapy. Among all 34 bone and soft tissue sarcomas, the success rate for limb salvage was 74%, while the recurrence rate was 18%. The functional result of the limb salvage operations was far better than that of ablative operations of the shoulder part. In fact the rate of satisfactory ADL (excellent and good) was 81% among the limb salvage cases, while for ablative operations, the ADL ratings were all poor.