PALLIATIVE MAJOR AMPUTATION AND QUALITY-OF-LIFE IN CANCER-PATIENTS

Limb sparing surgery has replaced the amputation surgery in the treatm ent of limb sarcomas. Recurrent or persistent disease constitutes a ma jor problem. Local symptoms such as agonizing pain, fractures, tumor f ungation, inability to walk and inability to maintain daily activities , further impair the patient's quality of life. In this clinical set-u p palliative amputation should be considered. Eighteen patients with s oft-tissue or bone sarcomas and 3 patients with metastatic carcinoma u nderwent palliative major amputation. Hemipelvectomy was performed in 3 patients, hip disarticulation in 10, knee disarticulation or below-k nee amputation in 3 patients, shoulder disarticulation in one patient and forequarter amputation in 4 patients. Local control of the disease and pain and improvement of the performance status were observed in 1 9 evaluable patients. The mobility was restored in 15 patients with lo wer limb surgery. The median survival following the procedure was 9 mo nths. There was only one case of immediate post-operative death. Sever e phantom pain was not reported by any of the patients. Quality of lif e was reported to be improved by two-thirds of the patients. To conclu de, we have found palliative major amputation surgery worth performing in low-performance status cancer patients with locally advanced disea se.