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Multicenter Study
. 2024 Jan 11;24(1):61.
doi: 10.1186/s12885-023-11813-2.

Amputation in patients with extremity soft tissue sarcoma: the experience of an East Asian referral center

Yongsung Kim  1   2 , Han-Soo Kim  1   3 , Ilkyu Han  4   5
Affiliations
Multicenter Study

Amputation in patients with extremity soft tissue sarcoma: the experience of an East Asian referral center

Yongsung Kim et al. BMC Cancer. .

Abstract

Background: This study aimed to investigate the characteristics and clinical outcomes in a series of patients with extremity soft tissue sarcoma (STS) who underwent amputation at a large East Asian referral center.

Patients and methods: Of the 652 patients who underwent surgery for extremity STS, data of 37 consecutive patients who underwent amputation were reviewed retrospectively. The median follow-up period was 96.0 months (range, 15-216). The patients were classified in to three cohorts. The primary localized (PL) group included patients who underwent amputation as a primary surgical procedure with curative intent. The recurrent localized (RL) group included patients who underwent amputation as a revision procedure after failure of previous limb sparing surgeries. The metastatic group included patients who underwent amputation as a palliative procedure.

Results: There were 22 cases of amputation in 596 STS patients and the amputation rate was 3.6% (22/596). Further, 1.8% (9/490) of patients with primary localized STS underwent amputation. Patients with localized STS who underwent amputation had a 5-year disease-specific survival (DSS) rate of 89.9% (95% Confidence Interval (CI), 87.1-92.7%), a local-recurrence-free survival (LRFS) of 84.1% (95% CI, 80.5-87.6%), and a metastasis-free survival (MFS) of 84.6%. (95% CI, 81.1-88.0%) Compared with previous studies, our results showed higher DSS and MFS rates with similar LRFS.

Conclusions: The amputation rate of extremity STS in our institute in East Asia was similar but slightly lower than that reported in Western studies. The oncologic outcome of amputation reported in this study was higher than that indicated in Western studies and oncologic outcome of amputation was not statistically different from those of limb salvage surgery. However, considering the small cohort in single institute study, there is a possibility of selection bias and future multi-center study is necessary. From our results, amputation is still a feasible option for appropriately selected patients unsuitable for limb-conserving surgery.

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Conflict of interest statement

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Survival analyses of amputation with localized diseases. (A) Disease-specific survival (P = 0.995), (B) Local recurrence-free survival (P = 0.503), and (C) Metastasis-free survival (P = 0.703) of primary localized group and recurrent localized group
Fig. 2
Fig. 2
Disease specific survival of amputation group and limb salvage surgery group. (P = 0.146)
See this image and copyright information in PMC

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