Scope and limitations of limb-sparing surgery in childhood sarcomas.
The authors reviewed 43 children with high-grade sarcomas of bone and soft tissue who underwent surgery during the past 9 years. Twenty-six patients had osteosarcoma, 7 had Ewing sarcoma, and 10 had soft tissue sarcomas. Patients ranged in age from 4 months to 13 years. Mean follow-up period was 6 years. The feasibility of resection, results of local resection, and failure of local disease control were reviewed. Limb salvage was feasible in 81% of patients. Of the 35 patients undergoing limb salvage, margins were considered adequate in 88% and inadequate in 12%. Limb-sparing resection was not feasible in 19% of patients. Five patients (four with metastatic disease at presentation) did not undergo surgery and were given palliative care; three other patients underwent amputation. The decision of whether to proceed with limb salvage surgery must depend on the aggressiveness of the underlying tumor, its stage, the feasibility of obtaining tumor-free resection margins, and the response to neoadjuvant therapy.
Kumta
Shekhar Madukar
SM
Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. sm-kumta@cuhk.edu.hk
Cheng
Jack Chun Yiu
JC
Li
Chi Kong
CK
Griffith
James F
JF
Chow
Louis T C
LT
Quintos
Albert D
AD
D000293:Adolescent; D000671:Amputation, Surgical; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012516:Osteosarcoma / Q000601:surgery*; D010166:Palliative Care; D012509:Sarcoma / Q000601:surgery*; D012512:Sarcoma, Ewing / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000601:surgery*