Forequarter amputation for malignancy

Abstract

In locoregional disease such as sarcoma, FQA may offer the only possibility of cure. However, in patients with axillary metastasis, FQA has no impact on survival, although local control may improve the patient's quality of life.

Major Upper-Limb Amputations for Malignant Tumors

“…This percentage could be higher because 42% of patients were lost to follow-up. Our results also appear poorer than those published more recently, 1,12 with the exception of the cohort of patients studied by Merimsky et al 10 However, all patients in that series had metastatic disease when they underwent palliative forequarter amputation. The poor patient survival in our study probably resulted from the large number of patients with distant metastases at the time of forequarter amputation (12 of the 26 patients; 46%).…”

“…Therefore, patients should be carefully counseled before an amputation is performed. Our survival outcomes for forequarter amputations appear worse than those previously published 1,4,5,9,10,12,14 (Table 2). Although the earlier series did not use the Kaplan-Meier method to estimate overall survival, 4,5,9,14 it appears that better overall survival was achieved with at least 14% 4 of the original cohort of patients surviving 5 years.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Even in recurrent tumors, amputation is typically performed only when limb preservation is no longer possible. 15,16 One reason why major upper-limb amputations are avoided is that, unlike lower limb prostheses, upperlimb prostheses are inadequate aesthetic and functional substitutes for the native limbs.…”

Forequarter amputation as a life-saving procedure

“…This procedure can be performed both as a curative and as a palliative intervention [6,8,10,11], and in selected patients, forequarter amputation can also be performed as a life-saving procedure. The purpose of this report is to highlight the importance of emergency surgical intervention for patients with a life-threatening condition such as extensive fungated, ulcerated or bleeding masses with an unstable haemodynamic condition.…”

Upper extremity reconstruction with a humeral tumor endoprosthesis: A novel salvage procedure after multiple revisions of total shoulder and elbow replacements

“…6,7,15,16,18 After bone tumor resection, the use of a humeral tumor endoprosthesis has been reported as a viable limb salvage alternative to FQA. 1,11,16,19 In addition, the implantation of a custom-made endoprosthetic reconstruction for the treatment of non-tumorous pathology of the distal humerus has also been reported in the treatment of failed primary elbow replacements and associated fracture complications. 3 To date, the application of a tumor endoprosthesis to address progressive humeral bone loss with shoulder girdle involvement has not been described.…”