{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T12:21:50Z","timestamp":1778934110740,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2001,6,1]],"date-time":"2001-06-01T00:00:00Z","timestamp":991353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2001,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Uncontrolled metastatic carcinoma of the shoulder girdle is a difficult oncologic problem. This study reviews our experience with palliative forequarter amputation with emphasis on patient selection criteria, preoperative radiologic assessment, surgical technique, epineural postoperative analgesia, and clinical outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eight patients who underwent palliative forequarter amputation for metastatic carcinoma between 1980 and 1999 were analyzed retrospectively. Diagnoses included breast carcinoma (n\u2009=\u20093), squamous cell carcinoma (n\u2009=\u20092), hypernephroma (n\u2009=\u20092), and carcinoma of unknown origin (n\u2009=\u20091). All patients presented with severe, intractable pain and a useless extremity. Venography demonstrated obliteration of the axillary vein in each of the patients in whom this procedure was performed. Exploration of the brachial plexus confirmed tumor encasement and unresectability in all patients. Epineural catheters for bupivacaine infusion were placed for postoperative pain control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients experienced dramatic pain relief and improved mobility and overall function. Life\u2010threatening hemorrhage and sepsis were alleviated. There were no instances of phantom limb pain or adverse psychological reactions, and no complications related to epineural analgesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Palliative forequarter amputation is relatively safe and reliable and provides effective pain relief for selected patients with unresectable metastatic carcinoma to the axilla and bony shoulder girdle in whom radiotherapy and\/or chemotherapy has not been effective. The triad of pain, motor loss, and an obliterated axillary vein is indicative of brachial plexus infiltration and unresectability. J. Surg. Oncol. 2001; 77:105\u2013113. \u00a9 2001 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.1079","type":"journal-article","created":{"date-parts":[[2004,10,27]],"date-time":"2004-10-27T12:44:12Z","timestamp":1098881052000},"page":"105-113","source":"Crossref","is-referenced-by-count":62,"title":["Palliative forequarter amputation for metastatic carcinoma to the shoulder girdle region: Indications, preoperative evaluation, surgical technique, and results"],"prefix":"10.1002","volume":"77","author":[{"given":"James C.","family":"Wittig","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Bickels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yehuda","family":"Kollender","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen L.","family":"Kellar\u2010Graney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac","family":"Meller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin M.","family":"Malawer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2001,6]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.79B6.7770"},{"key":"e_1_2_1_3_2","first-page":"1203","article-title":"The role of interscapulothoracic amputation in the treatment of malignant tumors","author":"El\u2010Domieri A","year":"1969","journal-title":"Surgery"},{"key":"e_1_2_1_4_2","first-page":"543","article-title":"The interscapulothoracic amputation in the treatment of malignant diseases of the upper extremity with a review of the literature","volume":"19","author":"Ham SJ","year":"1993","journal-title":"Eur J Surg Oncol"},{"key":"e_1_2_1_5_2","first-page":"1","article-title":"Major amputation for advanced malignant melanoma","volume":"169","author":"Jacques DP","year":"1989","journal-title":"Surgery"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199805000-00026"},{"key":"e_1_2_1_7_2","first-page":"359","article-title":"A technique of interscapulothoracic amputation","author":"Nadler SH","year":"1966","journal-title":"Surgery"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(195907\/08)12:4<643::AID-CNCR2820120403>3.0.CO;2-I"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1961.01300170050010"},{"key":"e_1_2_1_10_2","first-page":"796","article-title":"Interscapulothoracic amputation for the complications of breast cancer: A new approach","volume":"75","author":"Pressman PI","year":"1974","journal-title":"Surgery"},{"key":"e_1_2_1_11_2","first-page":"389","article-title":"The changing role of amputation for soft\u2010tissue sarcoma of the extremity in adults","volume":"175","author":"Willard WC","year":"1992","journal-title":"Surgery"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1006658"},{"key":"e_1_2_1_13_2","first-page":"756","article-title":"Diagnosis and management of brachial plexus lesions in cancer patients","volume":"9","author":"Kori SH","year":"1995","journal-title":"Oncology"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.222.11.1392"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.2930470212"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.3109\/02841869709109223"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0748-7983(95)95176-8"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19860915)58:6<1214::AID-CNCR2820580607>3.0.CO;2-9"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-199102000-00014"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19850915)56:6<1269::AID-CNCR2820560608>3.0.CO;2-Y"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197606)37:6<2677::AID-CNCR2820370616>3.0.CO;2-L"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19840715)54:2<228::AID-CNCR2820540209>3.0.CO;2-K"},{"key":"e_1_2_1_23_2","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1200\/JCO.1991.9.6.988","article-title":"Regional nodal failure after conservative surgery and radiotherapy for early\u2010stage breast carcinoma","volume":"9","author":"Recht A","year":"1991","journal-title":"J Clin Oncol"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(90)90029-D"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1098-7339(97)80011-9"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(88)90288-6"},{"key":"e_1_2_1_27_2","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199103000-00004"},{"key":"e_1_2_1_28_2","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/00003086-199105000-00035","article-title":"Postoperative infusional continuous regional analgesia, a technique for relief of postoperative pain following major extremity surgery","volume":"266","author":"Malawer MM","year":"1991","journal-title":"Clin Orthop"},{"key":"e_1_2_1_29_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199610000-00007"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjso.1079","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.1079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T11:21:35Z","timestamp":1700306495000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.1079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,6]]},"references-count":28,"aliases":["10.1002\/jso.1079.abs"],"journal-issue":{"issue":"2","published-print":{"date-parts":[[2001,6]]}},"alternative-id":["10.1002\/jso.1079"],"URL":"https:\/\/doi.org\/10.1002\/jso.1079","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,6]]}}}