Abstract
Oncological and functional prognostic factors for patients with foot sarcomas have yet to be clarified. This study was undertaken to identify the prognostic factors for oncological and functional outcomes and the significance of adjuvant radiotherapy in achieving local control in patients with foot sarcomas. We reviewed 31 consecutive patients with soft tissue (24), and bone (7) sarcomas arising in the foot and analyzed the impact of patient characteristics on the functional and oncological outcomes. There were seven cases with clear cell or epithelioid sarcomas. Two of the 31 cases experienced local recurrence despite the fact that only two cases received adjuvant radiotherapy. Sixteen out of 18 cases of soft tissue sarcomas with limb salvage surgery underwent reconstructive procedures for soft tissue defects. Amputation required as a surgical treatment (p=0.002) was a poor prognostic factor. Larger size (p=0.029) and bone reconstruction (p=0.018) were poor prognostic factors for local recurrence-free survival, and amputation (p=0.001) and bone reconstruction (p=0.008) for metastasis-free survival in patients with soft tissue sarcomas. No significant factors were derived in patients with bone sarcomas. Larger size (p=0.021), amputation (p=0.016) and bone reconstruction (p=0.03) were poor prognostic factors affecting function in patients with soft tissue sarcomas, and hindfoot site (p=0.028) and amputation (p=0.028) were poor prognostic factors affecting function in patients with bone sarcomas. Surgery with a negative operative margin and reconstructive procedures achieved good local control and function. Patients that had tumors with larger size, necessitating amputation or bone reconstruction, required novel multimodal treatment in order to improve their outcomes.