FOREQUARTER AMPUTATION FOR SOFT-TISSUE TUMORS

Forequarter amputation is a radical surgical procedure initially descr ibed for the treatment of traumatic injuries in 1908. This procedure h as been used more recently in the treatment of soft tissue tumors. Thi s 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 dis ease. Nine of these patients had soft tissue tumors and one a malignan t melanoma. Four patients underwent amputation as primary treatment of their tumor, and six underwent the procedure as treatment for recurre nt tumor. All patients are presently alive with a mean follow-up of mo re than 10 years. Three patients had recurrent tumor after the forequa rter amputation. One local failure was salvaged with a chest-wall rese ction, and two patients had distant failure. Forequarter amputation re mains an effective procedure for local control of tumors of varying hi stology involving the shoulder girdle and upper arm. The most common i ndication for this procedure is a recurrent soft tissue tumor for whic h limb sparing procedures are not applicable. Forequarter amputation s hould remain a rarely used, but important, surgical option for the tre atment of patients with soft tissue tumors.