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Interscapulomammothoracic Amputation for Malignant Melanoma

GEORGE T. PACK, M.D.; THOMAS A. McGRAW, M.D.
Arch Surg. 1961;83(5):694-699. doi:10.1001/archsurg.1961.01300170050010.
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When a cancer on an extremity originating in skin, bone, cartilage, or soft somatic tissue becomes otherwise uncontrollable, the common practice is to divorce the patient from this extremity and thereby remove the malignant tumor. The frequent failure of amputations to achieve long-time survivals of the patient may be attributed to two factors: (a) the inherent and unpredictable behavior of the cancer, and (b) procrastination in performing the major amputation due to reluctance on the part of both the patient and physician until the cancer becomes so advanced as to require an operation of desperation rather than one of hope. Major exarticulations of the extremities are done most commonly for soft-part sarcomas, next for malignant skin tumors, and least frequently for bone sarcomas. This order of frequency does not follow the natural incidence of these neoplasms. Less radical surgical measures suffice for most malignant tumors of the skin and soft

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