MANAGEMENT OF SOFT-TISSUE SARCOMA

A total of 485 patients with a proven or suspected diagnosis of soft t issue sarcoma were referred over a 3-year period. Of these, 61 were re ferred for opinion only and 424 for definitive treatment. Overall ther e were 223 patients with primary soft tissue sarcoma and 84 with recur rent sarcoma, 84 with benign soft tissue tumours and 22 with non-soft tissue sarcoma malignancy; 11 patients were referred with known metast atic disease. The commonest benign tumours mimicking soft tissue sarco ma were fibromatosis and benign intermuscular or intramuscular lipoma. The malignant tumours suspected clinically of being soft tissue sarco ma were bone tumours, lymphoma and metastatic carcinoma. Of the 172 pa tients with primary soft tissue sarcoma referred with a proven diagnos is this had been established by excision biopsy in 94 and open incisio n biopsy in 48. By contrast, of those undiagnosed at referral, 44 of 5 1 patients with soft tissue sarcoma had the diagnosis made by Tru-cut core biopsy. Amputation was performed in four of 165 patients with pri mary extremity soft tissue sarcoma and in five of 54 with recurrent ex tremity sarcoma, giving an overall amputation rate of 4 per cent. It i s proposed that the amputation rate for extremity soft tissue sarcoma can be reduced by the use of reconstructive procedures, particularly m yocutaneous flaps to the proximal limbs and limb girdles, and free vas cularized flaps to sites distal to the midthigh and midarm.