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

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.