Treatment of bone and soft tissue malignant tumours of the extremities by radical resection. A preliminary report of 12 cases.
Radical local resection is undoubtedly the method of choice in treating malignant bone and soft tissue tumours in the extremities, provided there is no local recurrence after radical resection. This is even truer today when the chemotherapy of osteosarcoma has achieved encouraging advances in preventing lung metastasis. The diagnostic methods for the evaluation of the tumour infiltration are at a more complete stage, and operative reconstruction techniques have als made rapid progress. Radical local resection is especially suitable for sarcomata of the extremities which are at an early stage, with less infiltrative low-grade malignancy. Amputation is better when the tumour grows rapidly and is large, if the soft tissue is widely infiltrated, if the patient is from 20 to 30 years old, and especially if the tumour is located in the upper tibia where it is difficult to carry out local resection. In this article, we report and discuss the definition, necessity, and possibility of radical local resection as well as the method of surgical reconstruction and our results. The results and prognosis for radical resection of giant-cell sarcoma, chondrosarcoma, and fibrosarcoma are rather good. Three of five cases of osteosarcoma died of lung metastasis one year after surgery. Therefore, improving the results in local resection of osteosarcoma calls for further investigation.