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Titolo:
Amputation for recurrent soft tissue sarcoma of the extremity: Indicationsand outcome
Autore:
Stojadinovic, A; Jaques, DP; Leung, DHY; Healey, JH; Brennan, MF;
Indirizzi:
Mem Sloan Kettering Canc Ctr, Dept Surg, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Mem Sloan Kettering Canc Ctr, Dept Biostat, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Cornell Univ, Weill Med Coll, Dept Surg, Ithaca, NY USA Cornell Univ Ithaca NY USA iv, Weill Med Coll, Dept Surg, Ithaca, NY USA
Titolo Testata:
ANNALS OF SURGICAL ONCOLOGY
fascicolo: 6, volume: 8, anno: 2001,
pagine: 509 - 518
SICI:
1068-9265(200107)8:6<509:AFRSTS>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROGNOSTIC FACTORS; RADIATION-THERAPY; MANAGEMENT; SALVAGE;
Keywords:
recurrent; extremity sarcoma; amputation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Brennan, MF Mem Sloan Kettering Canc Ctr, Dept Surg, 1275 York Ave, New York, NY 10021USA Mem Sloan Kettering Canc Ctr 1275 York Ave New York NY USA 10021
Citazione:
A. Stojadinovic et al., "Amputation for recurrent soft tissue sarcoma of the extremity: Indicationsand outcome", ANN SURG O, 8(6), 2001, pp. 509-518

Abstract

Background: Limb salvage after primary site failure of extremity soft tissue sarcoma is a challenging problem. Amputation may be the most effective treatment option in selected patients with local recurrence. We compared theoutcome of patients treated with amputation versus limb-sparing surgery (LSS) for locally recurrent extremity sarcoma,Methods: From 1982 to 2000, 1178 patients with localized primary extremitysarcoma underwent LSS. Of these, 204 (17%) developed local recurrence. Eighteen (9%) required major amputation and the remainder underwent LSS, of which 34 were selected for matched-pair analysis according to established prognostic variables. Rates of recurrence or death were estimated by the Kaplan-Meier method. Following adjustment for prognostic variables, a Mantel-Haenszel test was used to compare the outcome between the two treatment groups. Results: Patients in each group were well matched. All patients had high-grade tumors deep to the fascia. Median time to local recurrence was similarfor both groups. Median follow-up was 95 months. Amputation was associatedwith a significant improvement in local control of disease (94% vs. 74%; P=.04). We observed no difference in disease-free (P =.48), disease-specific (P =.74), or overall survival (P =.93) between the two groups. Median postrecurrence survival was 20 months and 5-year OS was 36% for the entire study group. Conclusions: Limb-sparing treatment achieves local control in the majorityof recurrent extremity sarcomas for which amputation is infrequently indicated. Amputation improves local disease control but not survival under these circumstances.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 09:27:37