Operations for Sarcomas on the Upper Extremity

Abstract

The general principles of soft-part resection apply to sarcomas arising in the upper extremity, but the relative proportion of patients requiring amputation is greater than with sarcomas in the lower extremities. The smaller muscle masses in the arm and forearm, when compared with the thigh and leg, do not allow as wide a soft-tissue margin around the sarcoma and, in many instances, this prevents limb preservation. Nevertheless, the soft-tissue resections for arm and forearm sites are described and illustrated. In each instance the procedure essentially includes resection of the entire muscle compartment and fits the category of radical compartmental resection, since this is usually required to achieve an adequate gross margin. When amputation is required, the standard techniques are employed for midarm and distal sites, but inter-scapulothoracic amputation is indicated for more proximal sites.