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

Background and ObjectivesPrimary 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. MethodsA 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). ResultsPF 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. ConclusionLimb-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.