Soft tissue sarcomas of the hand and foot

A retrospective study was made of 82 soft tissue sarcomas of the hand and foot. Prognosis was related to histopathologic grade of malignancy and success or failure of local tumor control. After treatment with curative intent, low-grade tumors gave a 5-year survival rate of 90%, compared to 63% for high-grade tumors. Simple excision or limited amputation of the digit, hand, or foot yielded a 5-year survival rate of 68% (15/22) and a local recurrence rate of 32%. Amputation below the elbow or knee or higher resulted in a similar survival of 68% (19/28) but no local recurrences. All patients who developed local recurrences died, except for two with low-grade tumors and one patient lost to follow-up. These observations indicate the need for systemic chemotherapy to prevent death from metastasis, and for effective local tumor control. Conventional radiation therapy may be difficult to apply at these sites. Innovative local treatment approaches to preserve limb function without jeopardizing tumor control merit study.