Last updated: 11/24/2009

Also called limb-sparing surgery, limb salvage involves removing the cancer and about an inch of healthy tissue surrounding it. In addition, if had been removed, the removed bone is replaced. The replacement can be made with synthetic metal rods or...

plates (prostheses), pieces of bone (grafts) taken from the patient's own body (autologous transplant), or pieces of bone removed from a donor body (cadaver) and frozen until needed for transplant (allograft). In time, transplanted bone grows into the patient's remaining bone. Chemotherapy, radiation, or a combination of both treatments may be used to shrink the tumor before surgery is performed.

Limb salvage is performed in three stages. Surgeons remove the cancer and a margin of healthy tissue, implant a prosthesis or bone graft (when necessary), and close the wound by transferring soft tissue and muscle from other parts of the patient's body to the surgical site. This treatment cures some cancers as successfully as amputation.

Surgical techniques

BONE TUMORS. Surgeons remove the malignant lesion and a cuff of normal tissue (wide excision) to cure low-grade tumors of bone or its components. To cure high-grade tumors, they also remove muscle, bone, and other tissues affected by the tumor (radical resection).

SOFT TISSUE SARCOMAS. Surgeons use limb-sparing surgery to treat about 80% of soft tissue sarcomas affecting extremities. The surgery removes the tumor, lymph nodes, or tissues to which the cancer has spread, and at least 1 in (2.54 cm) of healthy tissue on all sides of the tumor.

Radiation and/or chemotherapy may be administered before or after the operation. Radiation may also be administered during the operation by placing a special applicator against the surface from which the tumor has just been removed, and inserting tubes containing radioactive pellets at the site of the tumor. These tubes remain in place during the operation and are removed several days later.

To treat a soft tissue sarcoma that has spread to the patient's lung, the doctor may remove the original tumor, administer radiation or chemotherapy treatments to shrink the lung tumor, and surgically remove the lung tumor.