The Journal of Bone and Joint Surgery, Vol 74, Issue 1 28-35, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
Epithelioid sarcoma in the upper extremity
BD Steinberg, RH Gelberman, HJ Mankin and AE Rosenberg
Massachusetts General Hospital, Boston 02114.
Eighteen patients who had epithelioid sarcoma in the upper extremity were
divided into two groups on the basis of treatment: marginal resection of
the tumor or wide or radical resection of the tumor. Historical,
demographic, histological, and staging data were recorded and were
correlated with the type of treatment and the outcome. Marginal resection
(excision through the reactive zone or pseudocapsule surrounding the tumor,
with confirmation of a negative margin by a pathologist), with or without
adjuvant therapy, led to a dismal outcome in patients who had been treated
in this manner initially or secondarily (fifteen failures after seventeen
procedures). Disease-free survival at ten years was significantly improved
when wide resection (intracompartmental en bloc excision with a cuff of
normal tissue of more than three centimeters) or radical resection was
either the initial or the secondary treatment; success then was noted in
nine of thirteen operations. Of twelve patients in whom a marginal
resection had been done initially, three had had a recurrence, three had
had a metastasis, and five had died, at a mean follow-up of seven years
(range, twenty-seven months to sixteen years). At a mean follow-up of six
years (range, two to fifteen years), only one of five patients in whom a
secondary lesion had been treated with marginal resection was free of
disease. Of the six patients who had been treated with wide or radical
resection initially, none had died, one had had a recurrence, and one had
had a metastasis, at a mean follow-up of seven years (range, twenty-two
months to fourteen years).(ABSTRACT TRUNCATED AT 250 WORDS)
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