Functional and clinical outcomes of limb-sparing therapy for pediatric extremity sarcomas.
OBJECTIVE
To determine the clinical and functional outcomes of children undergoing limb-sparing therapy for extremity sarcomas.


METHODS
We retrospectively reviewed 30 patients, age < or = 21 years, who were treated between l979 and l998 with external beam radiotherapy as a component of limb-sparing therapy for primary sarcomas of the extremity at UCSF. Included were patients for whom complete follow-up and functional outcome assessments were available. We assessed the patterns of failure, overall survival, disease-free survival, local control, and limb function.


RESULTS
At a median follow-up of 3 years, 12 of the 30 patients recurred: 3 locally, 8 distantly, and 1 with synchronous local and distant disease as site of first progression. Eighteen patients were alive with no evidence of disease. The median overall survival was 10 years, with a median disease-free survival of 8 years. Functional outcome assessment revealed 15 patients retained excellent, 12 good, 1 fair, and 2 poor limb function.


CONCLUSIONS
In pediatric patients receiving limb-sparing therapy, 90% maintained excellent or good limb function without compromising survival, demonstrating the validity of limb preservation in children with extremity sarcomas.
Bertucio
C S
CS
Department of Radiation Oncology, University of California-San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0226, USA.
Wara
W M
WM
Matthay
K K
KK
Ablin
A R
AR
Johnston
J O
JO
O'Donnell
R J
RJ
Weinberg
V
V
Haas-Kogan
D A
DA
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005121:Extremities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local; D020127:Recovery of Function; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy*; D016019:Survival Analysis; D017211:Treatment Failure