Amputaciones mayores en cirugía oncológica. Análisis retrospectivo de 80 casos en el Instituto Nacional de Cancerología

Abstract

ObjectiveTo describe the epidemiological, clinical and treatment characteristics of patients with soft tissue tumours, melanoma, and squamous cell carcinomas of the Breast and Soft Tissue Department of the Instituto Nacional de Cancerologìa, who had major limb amputations between the years 1998 and 2008. Methodsa review was made of the clinical records of 80 patients in whom a major limb amputation was performed between January 1998 and December 2008 in the Breast and Soft Tissue Department of the Instituto Nacional de Cancerologìa. ResultsOf the 80 patients studied, 24 had a classic hemipelvectomy, 22 with hip disarticulation, 19 with interscapular-thoracic disarticulation, 8 with hemi-hemipelvectomy, and 7 with shoulder disarticulation. The diagnoses, in order of frequency were: soft tissue sarcomas, 72.5%; squamous cell carcinomas, 21.2%; and melanoma, 6.2%. The intention of the surgery was curative in 50% of the cases. There was a greater number of complications in the patients where the intention of the surgery was palliative, with a significant significance only for necrosis of flaps (22.5% vs. 5% P=.02). The one-year survival in the patients with intention to cure surgery was 67.5% vs. 42.5% for palliative surgery (P=.038). ConclusionsIn patients with tumours proximal to the limbs, where preservative surgery is impossible, major amputations continue to be a valid therapeutic option, despite its high rate of complications.