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dc.contributor.authorSmith, HGen_US
dc.contributor.authorThomas, JMen_US
dc.contributor.authorSmith, MJFen_US
dc.contributor.authorHayes, AJen_US
dc.contributor.authorStrauss, DCen_US
dc.coverage.spatialUnited Statesen_US
dc.date.accessioned2018-02-19T12:12:08Z
dc.date.issued2018-02en_US
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/28547562en_US
dc.identifier10.1245/s10434-017-5895-2en_US
dc.identifier.citationAnn Surg Oncol, 2018, 25 (2), pp. 387 - 393en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1282
dc.identifier.eissn1534-4681en_US
dc.identifier.doi10.1245/s10434-017-5895-2en_US
dc.description.abstractINTRODUCTION: With modern techniques facilitating limb conservation, amputation for extremity soft-tissue sarcoma (ESTS) is now rare. We sought to determine the indications and outcomes following major amputation for ESTS and whether amputation is prognostic of oncological outcomes in primary disease. PATIENTS AND METHODS: Patients undergoing major amputations for ESTS from 2004 to 2014 were identified from electronic patient records. RESULTS: The amputation rate in primary localized disease was 4.1%. Overall, 69 patients were identified, including 23 (33.3%) amputations for primary localized disease, 36 (52.2%) amputations for recurrent disease, and 10 (14.5%) amputations for metastatic disease. The local recurrence rate for localized disease at 3 years was 10.4%. Three-year overall survival (OS) was 50.3% following curative amputation, with a median survival of 41 months, and median OS following palliative amputation was 6 months. In the context of primary, localized disease, patients undergoing amputation had a greater proportion of high-grade tumors (69.6% vs. 41.1%; p = 0.009) of greater size (median 16.0 vs. 9.0 cm; p = 0.003) when compared with patients undergoing limb-conserving surgery. The rates of systemic relapse and disease-specific survival were poorer following amputation compared with limb-conserving surgery, however mode of surgery (amputation vs. limb conservation) was only prognostic for OS. CONCLUSIONS: Amputation maintains an important role in ESTS and achieves durable local control in those unsuitable for limb-conserving surgery. Survival following amputation in the presence of metastatic disease is poor and should be reserved for patients with significant symptoms.en_US
dc.format.extent387 - 393en_US
dc.languageengen_US
dc.language.isoengen_US
dc.subjectAdolescenten_US
dc.subjectAdulten_US
dc.subjectAgeden_US
dc.subjectAged, 80 and overen_US
dc.subjectAmputationen_US
dc.subjectExtremitiesen_US
dc.subjectFemaleen_US
dc.subjectFollow-Up Studiesen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectNeoplasm Metastasisen_US
dc.subjectNeoplasm Recurrence, Localen_US
dc.subjectPostoperative Complicationsen_US
dc.subjectPrognosisen_US
dc.subjectSarcomaen_US
dc.subjectSurvival Rateen_US
dc.subjectYoung Adulten_US
dc.titleMajor Amputations for Extremity Soft-Tissue Sarcoma.en_US
dc.typeJournal Article
rioxxterms.versionofrecord10.1245/s10434-017-5895-2en_US
rioxxterms.licenseref.startdate2018-02en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfAnn Surg Oncolen_US
pubs.issue2en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Sarcoma and Melanoma Surgery
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublisheden_US
pubs.volume25en_US
pubs.embargo.termsNot knownen_US
icr.researchteamSarcoma and Melanoma Surgeryen_US
dc.contributor.icrauthorHayes, Andrewen_US
dc.contributor.icrauthorSmith, Henryen_US
dc.contributor.icrauthorMarsden,en_US
dc.contributor.icrauthorSmith, Mylesen_US


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