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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 11, 1480-1486.
doi: 10.1302/0301-620X.88B11.17424  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Does the method of treatment affect the outcome in soft-tissue sarcomas of the adductor compartment?

A. Pradhan, BMedSc, MBChB (Hons), Foundation year-1 doctor1; Y. C. Cheung, MBChB, Foundation year-1 doctor2; R. J. Grimer, FRCS, Consultant Orthopaedic Oncologist3; A. Abudu, FRCS, Consultant Orthopaedic Surgeon3; D. Peake, FRCR, Consultant Oncologist3; P. C. Ferguson, FRCS(C), Orthopaedic Surgeon4; A. M. Griffin, MSc, Clinical Research Manager4; J. S. Wunder, FRCS(C), Orthopaedic Surgeon4; B. O’Sullivan, FRCP(C), Radiation Oncologist5; R. Hugate, Jr, MD, Orthopaedic Surgeon6; and F. H. Sim, MD, Professor of Orthopaedic Surgery7

1 Selly Oak Hospital, Raddlebarn Road, Birmingham B29 6JD, UK.
2 Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury SY3 8XQ, UK.
3 Royal Orthopaedic Hospital Oncology Service, Bristol Road South, Northfield, Birmingham B31 2AP, UK.
4 Suite 476E, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada.
5 Department of Radiation Oncology Radiation Medicine Program, Princess Margaret Hospital, University Health Network, 610 University Avenue, Toronto, Ontario, M5G 2M9, Canada.
6 The Denver Clinic for Extremities at Risk, 1601 East 19th Avenue, Suite 3300, Denver, Colorado 80218, USA.
7 Mayo Clinic 200 First Street SW, Rochester, Minnesota 55905, USA.

Correspondence should be sent to Mr R. J. Grimer; e-mail: rob.grimer{at}roh.nhs.uk

We have investigated the significance of the method of treatment on the oncological and functional outcomes and on the complications in 184 patients with soft-tissue sarcomas of the adductor compartment managed at three international centres. The overall survival at five years was 65% and was related to the grade at diagnosis and the size of the tumour. There was no difference in overall survival between the three centres. There was, however, a significant difference in local control with a rate of 28% in Centre 1 compared with 10% in Centre 2 and 5% in Centre 3.

The overall mean functional score using the Toronto Extremity Salvage Score in 70 patients was 77% but was significantly worse in patients with wound complications or high-grade tumours. The scores were not affected by the timing of radiotherapy or the use of muscle flaps.

This large series of soft-tissue sarcomas of the adductor compartment has shown that factors influencing survival do not vary across the international boundaries studied, but that methods of treatment affect complications, local recurrence and function.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General