|Table of Contents|

Application of vascular reconstruction in cases of extremity soft tissue sarcoma involving the major vessels

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 10
Page:
1909-1913
Research Field:
Publishing date:

Info

Title:
Application of vascular reconstruction in cases of extremity soft tissue sarcoma involving the major vessels
Author(s):
ZENG Jing; LI Zhui; REN Wei
Department of Vascular Surgery,First Affiliated Hospital of Chongqing Medical University，Chongqing 400000，China.
Keywords:
limb soft tissue sarcoma; limb salvage surgery; synthetic vascular reconstruction; vascular resection
PACS:
R738.6
DOI:
10.3969/j.issn.1672-4992.2023.10.026
Abstract:
Objective：To explore the clinical significance of synthetic vascular reconstruction in limb-sparing surgery for extremity soft tissue sarcoma involving the major vessels.Methods：The data of five cases of limb-sparing surgery with synthetic vascular reconstruction performed by our hospital from 2012 to 2022 were collected and analyzed in combination with the literature.Results：Total sarcoma resection combined with synthetic vascular reconstruction was done in all five cases in the group.There were two cases of leiomyosarcoma,one case of undifferentiated polymorphic sarcoma,one case of dedifferentiated liposarcoma,and one case of aggressive fibromatosis.Three femoral arteries,three femoral veins,and one subclavian artery were involved.One brachial plexus and one femoral nerve were involved.During the follow-up period,two patients developed local recurrence and two developed distant metastasis,one patient underwent three surgical treatments due to multiple recurrent or metastases.One case of vascular occlusion occurred,which was opened by endovascular intervention,and the remaining four cases were unobstructed.One patient died after four months of follow-up,with a maximum follow-up time of 10 years.Conclusion：The biological behavior characteristics of sarcoma are the crucial factors affecting vascular reconstruction,and the protection of peripheral nerves also needs attention.

References:

［1］ MLEES MA,ELBARBARY AH,SALLAM EM.Vascular reconstruction using autologous vs synthetic graft for patients with extremity soft-tissue sarcoma involving the major vessels ［J］.J Surg Oncol,2020,121:272-278.
［2］ VON MEHREN M,RANDALL RL,BENJAMIN RS,et al.Soft tissue sarcoma,version 2.2018,NCCN clinical practice guidelines in oncology ［J］.J Natl Compr Canc Netw,2018,16(5):536-563.
［3］ GHOSH J,BHOWMICK A,BAGUNEID M.Oncovascular surgery ［J］.Eur J Surg Oncol,2011,37(12):1017-1024.
［4］ SHAH A,RAMANUJAN V,MURALIDHARAN K,et al.Outcomes of vascular resection and reconstruction in extremity soft tissue sarcoma and bone tumors ［J］.Vasc Specialist Int,2021,37(1):22-28.
［5］ FORTNER JG,KIM DK,SHIU MH.Limb-preserving vascular surgery for malignant tumors of the lower extremity ［J］.Arch Surg,1977,112(4):391-394.
［6］ AKGUL T,SORMAZ IC,AKSOY M,et al.Results and functional outcomes of en-bloc resection and vascular reconstruction in extremity musculoskeletal tumors ［J］.Acta Orthop Traumatol Turc,2018,52(6):409-414.
［7］ POLATOVA D,SHARIPOV M,GAFUR-AKHUNOV M,et al.Microsurgical reconstruction of blood vessels during organ-preserving operations in patients with limb tumors［J］.European Journal of Surgical Oncology,2022,48(2):e167.
［8］ KUMAR S,MANJUNATH NML,GOWDA SM,et al.Limb preservation using vascular reconstruction in patients with large extremity soft tissue sarcomas:Results of multi-modality therapy ［J］.Indian J Surg,2020,82(6):1088-1093.
［9］ WOO HY,AHN S,MIN S,et al.Crucial roles of vascular surgeons in oncovascular and non-vascular surgery［J］.Eur J Vasc Endovasc Surg,2020,60(5):764-771.
［10］ 中国临床肿瘤学会指南工作委员会.中国临床肿瘤学会（CSCO）软组织肉瘤诊疗指南.2019［M］.北京:人民卫生电子音像出版社，2019：4-5. Guidelines Working Committee of Chinese Society of Clinical Oncology.Guidelines of Chinese Society of Clinical Oncology (CSCO) soft tissue sarcoma.2019［M］.Beijing:People's Health Electronic Audio & Video Publishing House，2019：4-5.
［11］ FLETCHER CDM,BRIDGE JA,HOGENDOORN PCW,et al.WHO classification of tumours of soft tissue and bone［M］.4th ed,Lyon:IARC Press,2013:1-2.
［12］ FUJIKI M,KIMURA T,TAKUSHIMA A.Limb-salvage surgery with vascular reconstruction after lower extremity sarcoma resection:A systematic review and meta-analysis［J］.Microsurgery,2020,40(3):404-413.
［13］ NISHINARI K,KRUTMAN M,JUNIOR SA,et al.Surgical outcomes of vascular reconstruction in soft tissue sarcomas of the lower extremities［J］.J Vasc Surg,2015,62(1):143-149.
［14］ PARK D,CHO S,HAN A,et al.Outcomes after arterial or venous reconstructions in limb salvage surgery for extremity soft tissue sarcoma ［J］.J Korean Med Sci,2018,33(40):e265.
［15］ QURESHI SS,M S,DHARESHWAR J,et al.Limb sparing surgery with vascular reconstruction for nonrhabdomyosarcoma soft tissue sarcoma in infants:A novel solution using allogenic vein graft from the parent ［J］.J Pediatr Surg,2020,55(8):1673-1676.
［16］ BERNER JE,DEARDEN A,MAGDUM AA,et al.Safety of limb-salvaging surgery for sarcomas compromising major vessels:A 15-year single-centre outcomes study ［J］.J Plast Reconstr Aesthet Surg,2021,74(9):2076-2084.
［17］ ADELANI MA,HOLT GE,DITTUS RS,et al.Revascularization after segmental resection of lower extremity soft tissue sarcomas ［J］.J Surg Oncol,2007,95(6):455-460.
［18］ OKAMOTO K,KOGA A,TAZUME H,et al.Early and mid-term outcomes after vascular reconstruction for patients with lower-extremity soft-tissue malignant tumors ［J］.Ann Vasc Dis,2018,11(2):228-232.
［19］ ASANO Y,YAMAMOTO N,HAYASHI K,et al.Clinical outcomes of limb-sparing tumor surgery with vascular reconstruction for bone and soft-tissue tumors［J］.Anticancer Research,2022,42(9):4619-4626.
［20］ ANGELINI A,PIAZZA M,PAGLIARINI E,et al.The orthopedic-vascular multidisciplinary approach improves patient safety in surgery for musculoskeletal tumors:A large-volume center experience ［J］.J Pers Med,2021,11(6):462.
［21］ HOMSY P,KANTONEN I,SALO J,et al.Reconstruction of the superficial femoral vessels with muscle flap coverage for soft tissue sarcomas of the proximal thigh［J］.Microsurgery,2022,42(6):568-576.
［22］ UMEZAWA H,SAKURABA M,MIYAMOTO S,et al.Analysis of immediate vascular reconstruction for lower-limb salvage in patients with lower-limb bone and soft-tissue sarcoma ［J］.J Plast Reconstr Aesthet Surg,2013,66(5):608-616.
［23］ TSUKUSHI S,NISHIDA Y,SUGIURA H,et al.Results of limb-salvage surgery with vascular reconstruction for soft tissue sarcoma in the lower extremity:Comparison between only arterial and arterovenous reconstruction ［J］.J Surg Oncol,2008,97(3):216-220.
［24］ MCKAY A,MOTAMEDI M,TEMPLE W,et al.Vascular reconstruction with the superficial femoral vein following major oncologic resection ［J］.J Surg Oncol,2007,96(2):151-159.
［25］ LEE DY,CHI JY,SEOK J,et al.Feasibility of brachial plexus schwannoma enucleation with intraoperative neuromonitoring ［J］.Clin Exp Otorhinolaryngol,2020,13(2):203-208.
［26］ GABA S,MOHSINA S,JOHN JR,et al.Clinical outcomes of surgical management of primary brachial plexus tumors ［J］.Indian J Plast Surg,2021,54(02):124-129.
［27］ NOOROMID MJ,THOMAS MA,YOON DY,et al.Outcomes of sarcoma resections requiring vascular surgical assistance:a single-center experience ［J］.Vasc Endovascular Surg,2020,54(7):579-585.
［28］ BOURCIER K,DINART D,LE CESNE A,et al.Outcome of patients with soft-tissue sarcomas:an age-specific conditional survival analysis ［J］.Oncologist,2019,24(7):e559-e564.
［29］ SWEITI H,TAMIMI N,BORMANN F,et al.Limb-salvage surgery of soft tissue sarcoma with sciatic nerve involvement ［J］.Sarcoma,2018,2018:6483579.
［30］ KATELNITSKAYA OV,NEPOMNYASHCHAYA EM,AUSHEVA TV,et al.Tumor thrombosis in extremity soft tissue sarcomas［J］.Journal of Clinical Oncology,2022,40(16):e23551.

Memo

Memo:
-
Last Update: 1900-01-01