Few studies of wound complications following limb salvage surgery for soft tissue sarcomas separate anatomical compartments. Forty-nine patients with adductor compartment sarcomas underwent limb salvage surgery, 43% developing significant wound complications, 25% requiring further surgery and 20% had delays in adjuvant radiotherapy as a result. Prior surgery by non tumour surgeons and previous radiotherapy led to an increased risk of wound healing problems. In this particular group of patients, special attention should be made to prevent wound healing complications, possibly involving plastic surgeons at an earlier stage of management.

Objective: To assess the validity of the Tokuhashi and Tomita scoring systems in the prediction of prognosis following spinal surgery for skeletal metastases.

Design: A retrospective cohort study of patients treated in a specialist spinal unit

Subjects: All patients undergoing definitive surgery for metastastes of the spine were considered eligible. Time to death or current length of survival was available in 147* of these which was confirmed by the Cancer Registry. Medical and nursing case notes were reviewed and prognostic scores using the methods of Tokuhashi et al, and Tomita et al. were calculated for each patient.

*

death data for further patients currently awaited from Cancer Registry.

Outcome measures: Mean survival period with 95% confidence intervals for patients grouped according to prognostic score.

Results: Thirty-two patients were still alive and 113 had confirmed death dates. Forty-three patients had Tokuhashi scores of 9 or greater with a mean survival of 20.1 months (95% confidence interval 5.8 months) compared to 9.5 months (2.9 months) for scores 6–8 and 3.5 months (1.8 months) for scores below this. Tomita scoring showed a similar trend with those with better prognostic profiles but without the same degree of statistical significance. The overall 30-day mortality was 8.2% with no significant difference between any other groups.

Conclusion: In patients presenting with metastatic disease involving the spine, published prognostic profiles offer some guidance to likely survival of the patient and so the appropriateness of surgical treatment.