Clinical outcome of total scapulectomy in 10 patients with primacy malignant bone and soft-tissue tumors

Background and Objectives: Limb reconstruction after total scapulectomy for malignant bone and soft-tissue tumors around the scapula is difficult. Thi s study was undertaken to clarify the clinical results of total scapulectom y in patients with malignant bone and soft-tissue tumors around the shoulde r girdle in our institute between 1984 and 1998. Methods: Ten patients undergoing total scapulectomy had an age range of 12- 82 years (average = 56 years). There were 5 cases of bone tumor and 5 cases of soft-tissue tumor. The follow-up period ranged from 8 months to 13 year s 5 months. Results: Seven patients are currently alive; the remaining 3 patients died of other diseases. One case of local recurrence was detected. The 2-year su rvival rate of all cases was 78.8%, and the 5-year survival rate was 52.5%. The average function evaluated by Enneking's criteria was 64.6%. Although the range of motion in the shoulder joint was seriously limited in all pati ents, the elbow and hand functions were almost normal. Recently, we have us ed a bone-anchoring system to suture between the clavicle and muscles, incl uding the biceps, triceps, and deltoid muscles. Conclusions: Patients who undergo total scapulectomy may achieve much bette r upper limb function than those who undergo forequarter amputation (inters capulothoracic amputation). (C) 1999 Wiley-Liss, Inc.