Conservative surgery and radiation therapy for soft tissue sarcoma of the wrist, hand, ankle, and foot

Seventy‐eight patients with soft tissue sarcoma (STS) arising in the distal extremities–wrist, hand, finger, ankle, foot, and toe–who were treated with conservation surgery and radiation therapy were studied retrospectively with respect to survival, local recurrence, functional limb preservation, co...

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Bibliographic Details
Published in:Cancer 1990-12, Vol.66 (12), p.2482-2491
Main Authors: Talbert, Michael L., Zagars, Gunar K., Sherman, Neil E., Romsdahl, Marvin M.
Format: Article
Language:English
Subjects:
Adult
Ankle
Combined Modality Therapy
Extremities
Female
Follow-Up Studies
Foot
Hand
Humans
Male
Middle Aged
Retrospective Studies
Sarcoma - mortality
Sarcoma - radiotherapy
Sarcoma - surgery
Sarcoma - therapy
Soft Tissue Neoplasms - mortality
Soft Tissue Neoplasms - radiotherapy
Soft Tissue Neoplasms - surgery
Soft Tissue Neoplasms - therapy
Wrist
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Summary:Seventy‐eight patients with soft tissue sarcoma (STS) arising in the distal extremities–wrist, hand, finger, ankle, foot, and toe–who were treated with conservation surgery and radiation therapy were studied retrospectively with respect to survival, local recurrence, functional limb preservation, complications, and distant metastasis. After a median follow‐up of 7.9 years, actuarial 5‐year and 10‐year survival rates were 80% and 69%, respectively, and disease‐free rates were 61% and 51% at the same times. Actuarial local control rates were 80% and 74% at 5 and 10 years, respectively. Fifteen patients (19%) had local recurrence, but 12 of these were salvaged. Ultimately, 53 patients (68%) retained a normal or fairly normal extremity, six (8%) needed amputation for complications, and 13 (17%) needed amputation to control recurrent disease. the functional outcome was significantly better for patients with upper extremity lesions than for those with lower extremity tumors; even for the latter, this treatment strategy was preferable to amputation. the incidence of hematogenous metastases from distal extremity sarcomas depends on the size of the primary tumor. It was concluded that conservation surgery and radiation therapy (XRT) is an acceptable treatment strategy for STS arising in distal extremities; it yielded a high rate of disease control and functional limb preservation.
ISSN:0008-543X
1097-0142
DOI:10.1002/1097-0142(19901215)66:12<2482::AID-CNCR2820661207>3.0.CO;2-L