Surgical treatment of bone and soft tissue tumors of the shoulder girdle.

Data on ninety-seven patients with tumors of the shoulder girdle underwent surgical treatment at Fukuoka University Hospital from August 1972 to September 1987 were analyzed. Fifty-six of these 97 consecutive patients with bone tumors (60) or soft tissue tumors (37) were treated surgically. Six patients were given an intra-arterial high-dose of adriamycin preoperatively. The 36 treated with simple resection or curettage and bone graft for benign tumor showed no evidence of local recurrence, except for 3 patients with bone cyst, Among the 20 treated with wide resection (limb salvage operation) for locally aggressive benign or malignant tumors, 11 patients (55%) were disease-free after a median follow-up of 18 months (among the 7 with primary malignant tumor 3 patients were continuously disease-free, 2 were disease-free after treatment of a local recurrence and 2 died.) Functions of the shoulder were studied in 12 patients who had undergone limb salvage operation. We wish to stress the importance of reconstruction of shoulder stability to preserve functions of the elbow and hand, particularly when diseased bone has been removed. If intra-articular resection can be accomplished for tumors of the proximal humerus, constrained total shoulder arthroplasty is an effective method of reconstruction of the surgical defect, yet will lead to preservation of a stable shoulder in patients whose deltoid muscle and axillary nerve have been spared. Preoperative and postoperative chemotherapy will increase the disease-free survival time and the percentage of functional limb saving procedures.