title: Outcome after disarticulation of the hip for sarcomas.
abstract: OBJECTIVE
  To review the oncological and functional outcome in 80 patients who underwent disarticulation of the hip as part of their treatment.
  
  
  METHODS
  Eighty patients had disarticulation, of whom 46 had a bone sarcoma and 34 a soft tissue sarcoma. In 42 patients the operation was done as the first definitive surgical procedure for that patient. In 38 patients the disarticulation followed local recurrence after unsuccessful limb salvage, three of these patients had palliative amputations already having metastatic disease. All patients had adjuvant therapy when appropriate.
  
  
  RESULTS
  The overall survival of the patients following the amputation was 56% at 1 year, 39% at 2 years, 27% at 5 years and 21% at 10 years. The 5-year survival of patients having the amputation as a primary procedure was 32%, for those with local recurrence it was 25% whilst for those with a palliative amputation it was nil. Local recurrence developed in 10 patients following the amputation, and was related to close margins of excision; all of these patients subsequently died. Function was on the whole poor, with only one surviving patient regularly using an artificial limb.
  
  
  CONCLUSIONS
  Disarticulation of the hip remains a disabling procedure usually carried out for high grade sarcomas with extensive involvement of bone and soft tissues in the thigh. Long term survival is possible if wide margins of excision can be achieved.
authors.affiliation: Royal Orthopaedic Hospital Oncology Service, Royal Orthopaedic Hospital, Bristol Road South, Birmingham B31 2AP, UK.
authors.forename: R
authors.initials: R
authors.lastname: Jain
authors.forename: R J
authors.initials: RJ
authors.lastname: Grimer
authors.forename: S R
authors.initials: SR
authors.lastname: Carter
authors.forename: R M
authors.initials: RM
authors.lastname: Tillman
authors.forename: A A
authors.initials: AA
authors.lastname: Abudu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality / Q000601:surgery*; D002648:Child; D004188:Disarticulation / Q000401:mortality; D005260:Female; D006615:Hip / Q000601:surgery*; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D012509:Sarcoma / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate