MID FOOT SARCOMA EXCISION AND FREE FLAP RECONSTRUCTION FOLLOWED BY RADIOTHERAPY COMBINES TUMOUR CLEARANCE AND PRESERVATION OF FUNCTION

Abstract

Aim: To review our series of mid foot sarcomas with regard to excision of tumour, tolerance of radiotherapy and preservation of function.

Methods and results: We identified 6 patients with mid foot sarcomas treated in our unit. Synovial sarcoma was the commonest diagnosis. All the patients had stage 1 disease with no evidence of pulmonary metastases at presentation. Patients judged to have resectable tumour but preserving sufficient foot to be functional were spared amputation. They had excision of the sarcoma and immediate reconstruction using fascio-cutaneous free flaps. Complete excision was achieved in all cases. One flap was lost and repeated. In all patients, subsequent radiotherapy was well tolerated without significant complications. All patients remain disease free. All patients have returned to pre-operative functioning including walking and jogging. All except one have returned to work.

Conclusion: Patients and feet treated by wide local excision of mid foot sarcomas and reconstructed by free fascio-cutaneous flaps tolerate post-operative radio-therapy well, and return to near normal function.