Is forequarter amputation justified for palliation of intractable cancer symptoms?
| Autor: | Isaac Meller, Jacob Bickels, Moshe Inbar, Shai Shabat, M. Gutman, Dina Lev-Chelouche, Yehuda Kollender, Doron Mazeh, Josephine Issakov, Ofer Merimsky |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Shoulder Adolescent medicine.medical_treatment Forequarter amputation Amputation Surgical Quality of life medicine Humans Cause of death Aged Retrospective Studies Aged 80 and over Performance status business.industry Palliative Care General Medicine Perioperative Middle Aged medicine.disease Surgery Radiation therapy Treatment Outcome Oncology Amputation Arm Quality of Life Female Sarcoma Neoplasm Recurrence Local business |
| Zdroj: | Oncology. 60(1) |
| ISSN: | 0030-2414 |
| Popis: | Background: Limb-sparing surgery has replaced the radical surgical approach for treating limb sarcomas in most cases. Amputation has been advocated as a palliative procedure for symptomatic locally advanced disease that has already failed to respond to radiation therapy, chemotherapy and limited surgery. Methods: Twelve patients with advanced malignant tumors involving the shoulder girdle or the proximal humerus underwent forequarter amputation (FQA) for palliative purposes. The tumor-related local problems were severe pain, limb dysfunction, tumor fungation, bleeding (requiring emergency FQA in one case) and infection. The preoperative Karnofsky performance status (KPS) in our series ranged from 30 to 70%. Results: No perioperative mortality was observed. The morbidity was well tolerated by the patients. The KPS improved in most of the patients, and was assessed as 90–100% in 9 of the 12 patients. Overall, quality of life was reported to be at least moderately improved by 2 out of 3 patients. Survival was measured in months (3–24 months), but ultimately had no meaning since the procedure was palliative. Lung metastases were the dominant cause of death in our patients. Conclusions: The results of FQA in our series point to its feasibility and the gain in quality of life and performance status in severely ill patients with advanced malignancies. Local symptoms and signs were controlled, and quality of life was restored. |
| Databáze: | OpenAIRE |
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