Treatment of regionally advanced XXXX of the extremity and trunk.

@entity1 @entity295 @entity5 @entity957 @entity204
A retrospective study was made of 106 locally and regionally advanced @entity957 of the trunk and extremity treated from 1949 to 1970. Forty-six of the @entity5 had a known cause, of which radiation exposure was the most common. In addition to axillary and inguinal nodal metastases, these @entity5 also manifested intransit, epitrochlear and popliteal lymphatic metastatic disease. Surgical treatment consisted of wide monobloc resection for the majority of the primary @entity5 , amputation being necessary for @entity5 fixed to skeletal or neurovascular structures. Clinically enlarged regional lymph nodes were subjected to biopsy, but elective regional node dissection did not offer therapeutic benefit. @entity1 with biopsy proved nodal metastases were treated by either radical nodal dissection or high exarticulation, with similar results. Actuarial five year survival rates after definitive surgical treatment were 71 per cent for @entity1 with regional node-negative and 57 per cent for those with regional node-positive @entity5 . Local and regional recurrences of @entity5 were frequent in @entity1 who had deep seated @entity5 of the trunk and postsacral region, or bulky nodal disease, despite pathologically negative resection margins. Uncontrolled recurrent @entity5 with @entity295 and compromise of vital organ function was the most common cause of @entity204 . Radiation therapy achieved partial regression of the @entity5 in eight @entity1 and complete regression in one of 15 @entity1 . A critical analysis is made of the various clinicopathologic factors which affect prognosis, and the possible means of improving the results of treatment are discussed.
