En-bloc resection for proximal humerus osteogenic sarcoma.

From 1975 to 1982, 101 children were treated for osteogenic sarcoma at the Children's Hospital of the Medical Center and Dana Farber Cancer Institute, Boston. 12 of these patients presented proximal humerus localisation and 8 underwent a local en-bloc resection. In the past these lesions were surgically treated by disarticulation of the shoulder or by interscapulothoracic amputation (forequarter amputation); the death rate was very high. Nowadays, high-dosage chemotherapy and resection of lung metastases carry new hopes for better and prolonged survival, and also for a higher rate of complete remissions. The quality of this prolonged life can be improved if en-bloc resection of the shoulder with upper limb preservation is performed.