title: Is there an indication for palliative surgical procedure of shoulder and upper limb malignancies?
abstract: OBJECTIVE
  Major amputation is not a frequent procedure at present, however, there is a group of patients still considered for these treatments. Our objective was to evaluate the results of this surgical intervention as well as to evaluate morbidity, local control, free disease, and palliation.
  
  
  METHODS
  The study included 57 patients on whom interscapulothoracic disarticulation (STDI) was carried out at the Instituto Nacional de Cancerología were (Mexico City) from 1974 to 1993. Patients with oncologic pathology were operated with a palliative aims. Twenty eight male and twenty nine female patients were found with average age of 44 years (range: 13 to 79 years). Clinical situation was characterized by tumor (100%), pain (46%), functional incapacity (39%), ulceration (32%), and bleeding (9%), Karnofsky 80% (range, 50 to 100). Time of evolution was 25 months (range: 1-121 months) and size was > 10 cm in 86% of cases.
  
  
  RESULTS
  Postoperative complications were present in ten, followed by patients follow infection in five cases, hematoma in the upper lung lobe in two and femoral thrombosis, skin wound necrosis, and bleeding in one case each. Palliation was evaluated to eliminate tumoral load, ulceration, bleeding, functional incapacity, and pre- and postoperative pain. Global survival was 12 months (range, 1-139 months).
  
  
  CONCLUSIONS
  Interscapulothoracic disarticulation is an infrequently performed surgery with low morbidity and mortality, low recurrence, no effect on survival, and excellent palliative results.
authors.affiliation: Department of Surgical Oncology, Instituto Nacional de Cancerología, San Fernando # 22, Tlalpan, 14000 México DF, México. kuauhyama@starmedia.com
authors.forename: Kuauhyama
authors.initials: K
authors.lastname: Luna-Ortiz
authors.forename: Eduardo
authors.initials: E
authors.lastname: Maafs-Molina
authors.forename: Angel
authors.initials: A
authors.lastname: Herrera-Gómez
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Barrera-Franco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000379:methods*; D001132:Arm / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D010166:Palliative Care; D012189:Retrospective Studies; D012782:Shoulder / Q000601:surgery*; D055815:Young Adult