Intraoperative extracorporeal autogenous irradiated tendon grafts for functional limb salvage surgery of soft tissue XXXX of the wrist and hand.

@entity1 @entity242 @entity5 @entity5426 @entity1352
BACKGROUND: In @entity1 with soft tissue @entity242 of the wrist and hand, limb salvage operation is extremely challenging for surgeons in attempting a complete @entity5 resection with negative surgical margins. In this study, we report four @entity1 with soft tissue @entity242 of the wrist and hand treated by limb salvage operation with intraoperative extracorporeal autogenous irradiated tendon grafts. METHODS: The @entity1 were all male, and the mean age at the time of surgery was 45 years. Histological diagnoses included clear cell @entity242 in two @entity1 , @entity1352 in one, and @entity5426 in one. All four @entity1 had high grade @entity5 , wherein three had American Joint Committee on Cancer (AJCC) @entity5 and one with AJCC stage IV disease. The @entity5 were resected en bloc with involved tendons. The tendons were isolated from the resected tissues, irradiated ex vivo, and re-implanted into the host tendons. In one @entity1 , the bone was resected additionally because of @entity5 invasion to the bone. Hand function was evaluated using Musculoskeletal Tumor Society (MSTS) rating system. RESULTS: Of the four @entity1 , three died of distant metastatic disease. The remaining @entity1 lives and remains disease-free. The mean follow-up period was 33 months. One @entity1 had local recurrence outside the irradiated graft at 20 months after surgery. The functional rating was 22. Lower scores were seen in @entity1 with reconstruction of flexor tendons than extensor tendons. CONCLUSIONS: Limb salvage operation with intraoperative extracorporeal autogenous irradiated tendon grafts is an acceptable method in selected @entity1 with soft tissue @entity242 of the wrist and hand.
