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THE ROLE OF SCAPULECTOMY IN SCAPULAR TUMOURS

Madras Medical College and Research Institute, Chennai, India

To evaluate the long term functional and the oncological outcomes of patients who underwent scapulectomy as a limb saving procedure for various tumours of the scapula.

A retrospective study was done in twenty-five patients who underwent scapulectomy for various tumours between 1989 and 2005. We describe twenty-three patients of scapular tumours who were followed up for a minimum of two years after surgery. Nineteen patients had malignant neoplasms of which chondrosarcoma was commonest, followed by Ewing’s sarcoma. Surgical staging was done using Enneking’s system; with stage II B being the commonest. Eight patients underwent subtotal scapulectomy of Malawer Type IIA and fifteen patients underwent total scapulectomy (Type III A). All patients with Ewing’s and Osteosarcoma received neoadjuvant chemotherapy.

With a follow-up ranging from 25–202 months, functional prognosis and oncological outcomes were evaluated for all patients. Two patients had superficial wound infections requiring antibiotics and one had skin necrosis requiring skin cover. Three patients died of pulmonary metastasis and the fourth patient died of local recurrence complicated by multiple metastasis. Functional results were analysed using Musculoskeletal Tumour Society scoring system. The Kaplan Meier 5-year survival computed in 19 patients with malignant tumours was 75.9%.

Scapulectomy is a more realistic option for bone and soft tissue tumours around shoulder girdle. It permits a curative, non-ablative, alternative to forequarter amputation in carefully selected patients.

The abstracts were prepared by Cormac Kelly. Correspondence should be addressed to The Secretary, British Elbow and Shoulder Society, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE