[Surgical technique and surgical-oncologic tactics in tumors of soft tissues and extremities with vascular...

Patients suffering from soft tissue sarcoma of the extremities may sometimes require vascular reconstruction to remove the tumor with adequate margins of clearance. Besides this, recurrent lymph node metastases are often affixed to neighboring vessels. MRI and angiography represent the adequate diagnostic procedures. Vessel-invasive sarcoma can hardly be treated by surgical resection with curative intent alone. If there is doubt about invasion of arteries and veins, the vessels should be resected and replaced by autologous vein graft. Soft tissue coverage is of major importance, particularly if prosthetic grafts are used or the resection is within an area of irradiated tissue. After radical resection and combined modality therapy, one can expect local recurrence rates similar to those without vessel invasion. To achieve this goal, surgical oncologists, vascular surgeons and plastic surgeons must work together. Today, amputation can hardly be justified even in vessel-invasive soft tissue tumors.