title: Forequarter amputation: a safe rescue procedure in a curative and palliative setting in high-grade malignoma of the shoulder girdle.
abstract: BACKGROUND
  Forequarter amputation (FQA) is a surgical treatment of tumors in the upper extremity and shoulder girdle that infiltrate the neurovascular bundles. In both curative and palliative settings, FQA can serve as an effective oncological treatment.
  
  
  METHODS
  This study presents the FQA-related data of 30 patients (mean age 50 years) treated between 2000 and 2012. Their medical condition was high-grade bone or soft tissue sarcoma in 26 and high-grade carcinoma in four cases.
  
  
  RESULTS
  Mean operation time was 119 min. One major and five minor complications occurred in the postoperative period. Resection margins were wide in 91 % of patients. Local recurrence was observed in four patients after 19 months on average. Patients treated with curative intention had a 5-year survival chance of 39 %. Average survival after palliative amputation was 11 months.
  
  
  CONCLUSIONS
  FQA provides an opportunity for adequate oncological margins in large tumors, while offering relief from tumor-induced distress in palliative situations.
authors.affiliation: Department of Orthopedics and Tumororthopedics, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. dernerv@web.de.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Elsner
authors.affiliation: Department of Orthopedics and Tumororthopedics, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Henrichs
authors.affiliation: Department of Orthopedics and Tumororthopedics, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Gosheger
authors.affiliation: Department of Orthopedics and Tumororthopedics, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Dieckmann
authors.affiliation: Department of Orthopedics and Tumororthopedics, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Nottrott
authors.affiliation: Department of Orthopedics and Tumororthopedics, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
authors.forename: Jendrik
authors.initials: J
authors.lastname: Hardes
authors.affiliation: Department of Orthopedics and Tumororthopedics, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Streitbürger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000145:classification / Q000379:methods*; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D002968:Clavicle / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010166:Palliative Care; D011379:Prognosis; D012540:Scapula / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D015996:Survival Rate; D055815:Young Adult
keywords: Forequarter amputation; High-grade sarcoma; Osteosarcoma; Shoulder girdle; Upper extremity