LIMB SALVAGE SURGERY AND ADJUVANT RADIOTHERAPY FOR SOFT-TISSUE SARCOMAS OF THE FOREARM AND HAND

Twenty-five consecutive patients with soft tissue sarcoma of the forea rm and hand were assessed for limb-salvage surgery and were entered in to a prospective study evaluating oncologic details and functional out come. Seventeen patients had received incomplete primary excision else where and presented with local recurrence or residual disease. Three h ad pulmonary metastases al the time of presentation. Twenty-three pati ents were candidates for limb-salvage surgery and 20 received adjuvant radiotherapy. The mean follow-up period was 37 months. There was loca l recurrence in three patients who had initially received marginal exc ision of the primary sarcoma, and three patients died of systemic dise ase. Limb function was assessed prospectively using both patient-based and clinician-based functional scoring systems and revealed good to e xcellent results in all but three patients. Eighty-eight percent of th ose who survived and did not require amputation were able to return to occupational and activities of daily living with no or minimal functi onal limitation. This study demonstrates that limb-salvage surgery, wi th adjuvant radiotherapy when necessary, is an effective alternative t o amputation in the majority of patients with sarcoma of the forearm a nd hand. Radiation toxicity is rarely a problem.