Analysis of clinical outcomes of upper and lower extremity reconstructions in patients with soft-tissue sarcoma

J Surg Oncol. 2018 Sep;118(4):614-620. doi: 10.1002/jso.25201. Epub 2018 Sep 9.

Abstract

Background and objectives: Primary amputations have been the standard of treatment for extremity soft tissue sarcomas. However, over the last few decades, this mode of treatment has been increasingly replaced by limb-sparing procedures.1 Our goal is to report the clinical outcomes of upper and lower extremity reconstructions in patients with a history of soft-tissue sarcoma.

Methods: A retrospective review of 178 patients with a history of soft-tissue sarcoma who underwent upper or lower extremity reconstructions was conducted. Demographics, tumor characteristics, treatment modalities, type of flap utilized, functional outcomes, and postoperative donor-/recipient-site complications (DSC/RSC) were analyzed. Variables were compared between free and pedicle flaps (FF or PF).

Results: PF reconstructions had a higher rate of DSC (P < 0.044), whereas FF reconstructions had a higher rate of RSC (P < 0.03). Upper extremity reconstruction resulted in a mean QuickDASH score of 5.98 (SD 9.37) with no significant difference between PF and FF. Lower extremity reconstruction resulted in a mean score of 71.2 (SD 10.7) for PF and 71.3 (SD 5.1) for FF on the Lower Extremity Function Scale.

Conclusion: Limb-preserving reconstruction with PF and FF is a reliable and safe option after sarcoma resection. In addition, long-term outcomes are promising and reassure the adequate functionality of the limb.

Keywords: limb reconstruction; patient outcomes; sarcoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Limb Salvage*
  • Lower Extremity / pathology
  • Lower Extremity / surgery*
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications*
  • Retrospective Studies
  • Sarcoma / pathology
  • Sarcoma / surgery*
  • Surgical Flaps
  • Treatment Outcome
  • Upper Extremity / pathology
  • Upper Extremity / surgery*
  • Young Adult