Upper extremity reconstruction following resection of soft tissue sarcomas: a functional outcomes analysis.
BACKGROUND
Treatment for soft tissue sarcoma of the upper extremity has evolved to include limb salvage techniques. We reviewed our experience with limb salvage therapy for upper extremity sarcomas with an emphasis on functional outcomes following the reconstructive surgery.


METHODS
A retrospective analysis was performed of 81 consecutive patients with soft tissue sarcoma of the upper extremity who had limb salvage therapy with reconstruction by a plastic surgeon. Univariate and multivariate regression analyses of relevant outcome variables were performed. Enneking functional scores were obtained from 43 patients.


RESULTS
The study included 16 microvascular reconstructions and 67 non-microvascular reconstructions for a total of 83 reconstructions in 81 patients. The mean defect size was 129 cm(2) (standard deviation: 106 cm(2)). The mean total functional score was 23.1 (range, 9 to 30). Any reconstruction-related complication and preoperative chemotherapy use were associated with a 7.3 point (P = .03) and 4.7 point (P = .01) decrease in total functional score, respectively. Kaplan-Meier product-limit analysis showed 82% 5-year overall survival and 67% 5-year disease-free survival rates.


CONCLUSIONS
For soft tissue sarcoma of the upper extremity, limb salvage with good functional outcome is possible with a judicious approach to reconstruction.
Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 443, Houston, TX 77030, USA.
John Y
JY
Kim
Adel
A
Youssef
Vairavan
V
Subramanian
Bruce A
BA
Rogers
Raphael E
RE
Pollock
Geoffrey L
GL
Robb
David W
DW
Chang
D000328:Adult; D000368:Aged; D001132:Arm / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012044:Regression Analysis; D012189:Retrospective Studies; D016879:Salvage Therapy; D012509:Sarcoma / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome