Abstract
Background
The objectives of this study were to clarify whether localized extremity soft tissue
sarcoma (STS) patients who underwent amputation surgery experienced worsened survival
and to identify those patients for whom amputation surgery worsened survival.
Methods
Using the Surveillance, Epidemiology, and End Results database, we identified 8897
patients with localized extremity STS between 1983 and 2016. Of these 6431 patients,
733 patients underwent amputation surgery (Amputation group), and 5698 underwent limb-sparing
surgery (Limb-sparing group).
Results
After adjusting for patient background by propensity score matching, a total of 1346
patients were included. Patients in the Amputation group showed worsened survival
(cancer-specific survival (CSS): hazard ratio (HR) = 1.42, 95% confidence interval
(CI) 1.15–1.75, overall survival (OS): HR = 1.41, 95%CI 1.20–1.65). In subclass analysis,
patients with high-grade STS, spindle cell sarcoma and liposarcoma in the Amputation
group showed shortened survival (high-grade–CSS: HR = 1.44, 95%CI 1.16–1.77, OS: HR = 1.38,
95%CI 1.18–1.62; spindle cell sarcoma–CSS: HR = 4.75, 95%CI 1.56–14.4, OS: HR = 2.32,
95%CI 1.45–3.70; liposarcoma–CSS: HR = 2.91, 95%CI 1.54–5.50, OS: HR = 2.32, 95%CI
1.45–3.70).
Conclusions
Survival was shortened in localized extremity STS patients who received amputation
surgery.
Keywords
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Article info
Publication history
Published online: March 15, 2023
Accepted:
February 26,
2023
Received in revised form:
February 21,
2023
Received:
November 1,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
