Vascular reconstruction after retroperitoneal and lower extremity sarcoma resection

Area of Science:

• Oncology
• Vascular Surgery
• Surgical Pathology

Background:

• Soft tissue sarcomas (STS) invading major blood vessels are rare and challenging malignancies.
• Management of retroperitoneal and lower extremity STS with vascular infiltration requires specialized surgical approaches.

Purpose of the Study:

• To analyze the outcomes of patients undergoing vascular replacement during resection of STS.
• To evaluate survival, graft patency, and limb salvage rates in these complex cases.

Main Methods:

• Retrospective single-center study of 47 patients (1990-2014) with retroperitoneal or lower extremity STS and arterial or combined arterial/venous infiltration.
• Exclusion of patients with sole major vein infiltration.
• Follow-up included medical records, general practitioner contact, and clinical examination.

Main Results:

• Median follow-up was 24.5 months, with median survival of 113 months and tumor-free survival of 25 months.
• Two-year arterial bypass patency was 88% in the retroperitoneum and 66% in the lower extremity.
• Limb salvage rate was 89%.

Conclusions:

• Major vascular invasion is not an absolute contraindication for STS resection.
• Surgical resection with vascular reconstruction is the only curative option and should be offered.
• High postoperative morbidity is associated with these procedures.