Is limb-sparing surgery applicable to neurogenic sarcomas of the extremities?

J. S. Bolton, J. N. Vauthey, G. H. Farr Jr, E. I. Sauter, J. C. Bowen 3rd and D. G. Kline
Department of Surgery, Ochsner Clinic, New Orleans, LA 70121.

The presentation, treatment, and outcome of 12 patients with high-grade neurogenic sarcoma (NS) of the extremity were compared with those of 21 patients with high-grade extremity soft-tissue sarcoma of nonneural origin in a retrospective study from January 1976 to January 1988. Pain and neurologic deficit were more common in the NS group. Limb-sparing surgery was carried out with equal frequency in both groups. Local recurrence was six times more frequent in the NS group at three-year follow-up (59% vs 10%). Width of resection margin was the dominant prognostic variable bearing on local control after limb-sparing surgery. Anatomic and functional constraints tended to limit resection margin in patients with NS arising from mixed motor-sensory or predominantly motor nerves.