Forequarter amputation for soft tissue tumors

Forequarter amputation is a radical surgical procedure initially described for the treatment of traumatic injuries in 1908. This procedure has been used more recently in the treatment of soft tissue tumors. This report describes the experience in the Division of Surgical Oncology at the University of Illinois over a 20-year period. Between 1970 and 1991, 10 patients underwent forequarter amputations for malignant disease. Nine of these patients had soft tissue tumors and one a malignant melanoma. Four patients underwent amputation as primary treatment of their tumor, and six underwent the procedure as treatment for recurrent tumor. All patients are presently alive with a mean follow-up of more than 10 years. Three patients had recurrent tumor after the forequarter amputation. One local failure was salvaged with a chest wall resection, and two patients had distant failure. Forequarter amputation remains an effective procedure for local control of tumors of varying histology involving the shoulder girdle and upper arm. The most common indication for this procedure is a recurrent soft tissue tumor for which limb sparing procedures are not applicable. Forequarter amputation should remain a rarely used, but important, surgical option for the treatment of patients with soft tissue tumors.