Soft tissue sarcomas of the hand and foot: management and survival.
BACKGROUND
Soft tissue sarcomas of the hands and feet present a challenge for limb-preserving resections.


METHODS
A retrospective review of 19 patients with sarcomas of the hand or foot was done. Wide or local excision was performed in 14 patients (74%), and amputation in 5 patients (26%). Of the latter group, three amputations involved a digit or toe, and two (10%) were major amputations (one Syme amputation and one below-knee amputation). When the minimum surgical margin was narrow (1 to 2 mm), adjuvant radiation was given postoperatively (n = 4).


RESULTS
Local recurrence was observed in four patients (21%). Two of these required an amputation for local control. Local recurrence was observed in one of four patients (25%) treated with marginal resection and radiation and three of 15 (20%) of those with resection alone.


CONCLUSIONS
A sizable percentage (37%) of patients with soft tissue sarcomas of the hand and foot ultimately required an amputation, although often the amputation was a minor one involving only a toe or a digit. Limb preservation was successful in the majority of patients (63%). The local recurrence rate was 21%, which may be improved with more frequent use of adjuvant therapy. The 5-year survival rate was 82%, which is better than that usually quoted for overall extremity soft tissue sarcomas.
Karakousis
C P
CP
Millard Fillmore Health System, State University of New York, Buffalo 14209, USA.
De Young
C
C
Driscoll
D L
DL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005534:Foot Diseases / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D016896:Treatment Outcome