Abstract
Simple SummarySarcomas are malignant tumors of soft tissues or bone. While limb salvage surgery (LSS) is the standard treatment, amputation is an option especially in local recurrence (LR) or complications after LSS. Two groups with primary amputations (n = 120) or secondary amputations after failed LSS due to LR or complications (n = 29) were compared. Five-year LR-free survival was 84% and 17 (16%) patients developed LR, of which 16 were in group I and only one in group II. Overall survival (OS) at five years was 44%, and the rate was identical in both groups. In those group II patients who had a secondary amputation after LSS due to contaminated margins or LR (n = 12) five-year OS was 33% compared to 48% in patients with complications (n = 17). This study indicates the worse oncological outcomes with respect to OS of sarcoma patients needing an amputation as compared to LSS. Patients with primary amputation or those who had a secondary amputation after failed LSS for whatever reason showed the same results.Background: Sarcomas are rare, malignant tumors of soft tissues or bone. Limb salvage surgery (LSS) is the standard treatment, but amputation is still an option, especially in local recurrence or complications after LSS. Methods: We retrospectively reviewed indications and oncological outcomes in patients who underwent an amputation. Two groups with either primary amputations (n = 120) or with secondary amputations after failed LSS with local recurrence or complications (n = 29) were compared with the main end points of LRFS and OS. Results: Five-year LRFS was 84% with 17 (16%) patients developing local recurrence, of which 16 (13%) occurred in group I. Forty-two (28%) patients developed metastatic disease and overall survival at five years was 44%. Overall survival (OS) was the same in both groups. In those group II patients who had a secondary amputation due to LR or insufficient margins after LSS (n = 12) the five-year OS was 33% compared to 48% in patients with amputation due to complications (n = 17) (n.s.). Conclusions: This study indicates the worse oncological outcomes with respect to OS of sarcoma patients requiring an amputation as compared to LSS. Patients with primary amputation or those who had a secondary amputation after failed LSS for whatever reason showed the same oncological results.
Highlights
Sarcomas are rare, malignant tumors of soft tissues or bone with an incidence of about 2 per 100,000 inhabitants and a predilection for the lower extremities [1,2,3,4,5]
After approval by our Institutional Review Board, we retrospectively reviewed 149 sarcoma patients who had undergone amputation at the authors’ institution between 1980 and 2018
In Group II, those patients having a secondary amputation due to local recurrence (LR) or insufficient margins after Limb salvage surgery (LSS) (n = 12), five-year Overall survival (OS) was 33% compared to 48% in patients with secondary amputation due to complications (n = 17) (n.s.)
Summary
Malignant tumors of soft tissues or bone with an incidence of about 2 per 100,000 inhabitants and a predilection for the lower extremities [1,2,3,4,5]. Limb salvage surgery has since become the standard treatment in extremity sarcoma surgery [7]. Malignant tumors of soft tissues or bone. Limb salvage surgery (LSS) is the standard treatment, but amputation is still an option, especially in local recurrence or complications after LSS. Two groups with either primary amputations (n = 120) or with secondary amputations after failed LSS with local recurrence or complications (n = 29) were compared with the main end points of LRFS and OS. Forty-two (28%) patients developed metastatic disease and overall survival at five years was 44%
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