Vascular reconstruction for limb salvage in soft tissue sarcomas

Area of Science:

• Orthopedic Oncology
• Vascular Surgery
• Surgical Oncology

Background:

• Soft-tissue sarcomas of the lower extremity can involve major vascular structures, posing a challenge for limb salvage.
• Resection of these tumors often necessitates the removal and reconstruction of major arteries and veins.

Observation:

• Ten patients with lower extremity soft-tissue sarcomas underwent resection of major vessels, with reconstruction using vascular grafts.
• Vessel involvement included iliac, femoral, and posterior tibial arteries.
• Nine synthetic and one reversed saphenous vein graft were used for arterial reconstruction.

Findings:

• Eight patients underwent curative resection with successful arterial reconstruction; none experienced local recurrence at a mean follow-up of 24.8 months.
• Six of nine patients who underwent curative resection are alive and well at a mean follow-up of 27 months.
• Complications included two graft thromboses, two instances of moderate swelling, and one graft infection requiring amputation.

Implications:

• Limb salvage surgery involving major vessel resection and reconstruction is an effective treatment for lower extremity soft-tissue sarcomas.
• Vascular reconstruction techniques can achieve durable local control and improve survival rates.
• This approach is a preferable alternative to amputation in select cases.