Limb salvage surgery without radiation therapy for soft tissue sarcomas of the foot

Abstract Combined limb salvage surgery and radiation therapy has been gaining traction for the treatment of soft tissue sarcomas of the foot in recent years. However, limb salvage surgery without radiation therapy is more desirable. In this study, we obtained good results from limb salvage surgery without radiation therapy in soft tissue sarcoma of the foot. Twenty patients histologically diagnosed with soft tissue sarcoma who underwent limb salvage surgery, including ray amputation, were evaluated. Their mean age was 39 years. The mean follow-up period was 94.5 months (6–355 months). The histological diagnoses included 9 cases of synovial sarcoma. Treatment, local recurrence rate, survival rate, complication, and ADL were evaluated. Surgical procedures consisted of ray amputation in 5 cases and limb salvage surgery in 15. Of these 15 cases, 14 (93%) required reconstructive surgery for skin defects. One patient (5%) exhibited recurrence. The 5-year overall survival rate was 94.7%, and the 5-year local progression-free survival rate was 92.9%. Early postoperative complications were found in 5 of 20 cases (25%), comprising flap failure in 4 cases and infection in 1 case; however, all patients eventually demonstrated good functional outcomes. In this study, the recurrence rate was 5% for patients who underwent limb salvage surgery without radiation therapy, and we obtained good local control. Since the anatomical structures of the foot act as barriers to tumor progression, the use of a method of evaluating resection margins to determine the extent of resection enabled successful surgery, not combined with radiation, without the recurrence of sarcomas.