Extended ray resection for sarcoma of the hand: long-term survival and functional results

Abstract

In this retrospective study, we analysed the long-term oncological and functional results after extended ray resection for sarcoma of the hand. Recurrence-free and overall survivals were calculated using the Kaplan–Meier method. The function of the operated hand was assessed with the Michigan Hand Questionnaire and compared with the contralateral side. Extended ray resection was performed in 25 out of 168 consecutive patients with soft-tissue and bony sarcomas of the hand. The overall 5- and 10-year, disease-specific survival rates were 86% and 81%, respectively. Local recurrences were observed in two patients. The Michigan Hand Questionnaire score for the affected hand at follow-up in nine patients was 82 points versus 95 for the healthy contralateral hands. We conclude that extended ray resection of osseous sarcomas breaking through the bone into the soft tissue or for soft tissue sarcomas invading bone is a preferable alternative to hand ablation when excision can be achieved with tumour-free margins. Level of evidence: III

Metacarpal reconstruction with a medial femoral condyle flap based on a 3D-printed model: a case report

“…Surgical procedures basically involve ray resection as well as metacarpal reconstruction using various techniques. The former allows an extended resection, which is especially important in tumor entities with aggressive infiltration; hence, a low recurrence rate can be achieved, if tumor-free excision margins can be achieved during initial surgery [ 9 ]. Moreover, ray resection leads to immediate, good functional results with low complication rates if negative margins (R0) were accomplished.…”

Classic Type of Epithelioid Sarcoma of the Distal Upper Extremity: Clinical and Oncological Characteristics

“…Depending on the size of the tumor, localization on the distal upper extremity, relationship to the critical structures of this organ, and previous therapies, finger/ray amputation or extended resection including complex reconstruction, or limb amputation was performed. 14 , 15 In case of positive resection margins and lack of options for further surgery to improve local control, amputation was discussed with patients. If the patient refused an amputation, limb-sparing therapy for recurrence according to the protocols of the interdisciplinary tumor board was initiated.…”