Literature DB >> 11078615

Soft tissue sarcomas of the lower extremity: surgical treatment and outcome.

P Popov1, E Tukiainen, S Asko-Seljaavaara, R Huuhtanen, M Virolainen, P Virkkunen, C Blomqvist.   

Abstract

AIMS: The aims of this retrospective follow-up study were to evaluate the justification for limb-saving multi-disciplinary treatment of soft tissue sarcomas (STS) and to report the results achieved by our treatment protocol. Local control was studied, with emphasis on tumour depth, operation margin and need for post-operative radiotherapy.
METHODS: We examined 130 patients with STS in the lower limb referred to the multi-disciplinary group of Helsinki University Central Hospital. For the survival analysis 106 patients with local disease remained. The goal of treatment was to preserve a functional limb. Wide excision was attempted. If the margin was less than 2.5 cm, post-operative radiotherapy (RT) was delivered to all except 20 patients.
RESULTS: Ninety-two per cent of the patients were treated by limb salvage. The success rate of free flaps was 16 out of 18. The 5-year disease-specific overall survival was 76%, metastasis-free survival 72% and local control 79%. Prognostic factors for local recurrence were extracompartmental site and large size; for development of metastases high grade, extracompartmental site and large size; for decreased disease-specific overall survival high grade, large size and advanced age. Local control of intramuscular tumours (n=6) was 100%, subcutaneous tumours (n=38) 94% and tumours penetrating the deep or muscle fascia and those locating extracompartmentally (n=62) 67%.
CONCLUSIONS: Limb salvage in patients with STS is possible with an acceptable outcome by selective combination of treatment modalities. Modern plastic surgical methods with free tissue transfers are successful and often needed. Subcutaneous and intramuscular tumours have good local control. The outcome is poorest for tumours penetrating the deep or muscle fascia and for those located extracompartmentally, and patients with such tumours might be a target for adjuvant therapy. Treatment should be coordinated by multidisciplinary teams. Copyright 2000 Harcourt Publishers Ltd.

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Year:  2000        PMID: 11078615     DOI: 10.1053/ejso.2000.0980

Source DB:  PubMed          Journal:  Eur J Surg Oncol        ISSN: 0748-7983            Impact factor:   4.424


  11 in total

1.  Case series. Soft-tissue sarcoma of the foot.

Authors:  L Daniel Latt; Robert E Turcotte; Marc H Isler; Cynthia Wong
Journal:  Can J Surg       Date:  2010-12       Impact factor: 2.089

2.  Primary appendicular soft-tissue sarcoma resection: What tumour parameters affect wound closure planning?

Authors:  Derek T Cawley; Peter Barrett; Barry Moran; Niall P McGoldrick; Charles Gillham; Mary Codd; Gary C O'Toole; David C Kieser
Journal:  Int Wound J       Date:  2019-10-13       Impact factor: 3.315

3.  Surgical margins and handling of soft-tissue sarcoma in extremities: a clinical practice guideline.

Authors:  R Kandel; N Coakley; J Werier; J Engel; M Ghert; S Verma
Journal:  Curr Oncol       Date:  2013-06       Impact factor: 3.677

Review 4.  Primary multidisciplinary management of extremity soft tissue sarcomas.

Authors:  Paul Clarkson; Peter C Ferguson
Journal:  Curr Treat Options Oncol       Date:  2004-12

5.  The Role of Plastic Reconstructive Surgery in Surgical Therapy of Soft Tissue Sarcomas.

Authors:  Rebekka Götzl; Sebastian Sterzinger; Andreas Arkudas; Anja M Boos; Sabine Semrau; Nikolaos Vassos; Robert Grützmann; Abbas Agaimy; Werner Hohenberger; Raymund E Horch; Justus P Beier
Journal:  Cancers (Basel)       Date:  2020-11-26       Impact factor: 6.639

6.  Impact of surgical margin on survival in extremity soft tissue sarcoma: A systematic review and meta-analysis.

Authors:  Woo Young Jang; Han-Soo Kim; Ilkyu Han
Journal:  Medicine (Baltimore)       Date:  2021-01-22       Impact factor: 1.889

7.  Limb conservation in extremity soft tissue sarcomas with vascular involvement.

Authors:  Rajaraman Ramamurthy; Jagadish Chandra Bose Soundrarajan; Viswanathan Mettupalayam; Subbiah Shanmugham; Balasubramanian Arumugam; Saravanan Periasamy
Journal:  Indian J Orthop       Date:  2009-10       Impact factor: 1.251

8.  Functional reconstruction of sarcoma defects utilising innervated free flaps.

Authors:  Damien Grinsell; Claudia Di Bella; Peter F M Choong
Journal:  Sarcoma       Date:  2012-08-28

9.  Lower Limb Core Scale: a new application to evaluate and compare the outcomes of bone and soft-tissue tumours resection and reconstruction.

Authors:  Andrea Monticelli; Davide Ciclamini; Michele Boffano; Elena Boux; Paolo Titolo; Bernardino Panero; Bruno Battiston; Raimondo Piana; Pierluigi Tos
Journal:  Biomed Res Int       Date:  2014-08-03       Impact factor: 3.411

Review 10.  Soft Tissue Coverage of the Lower Limb following Oncological Surgery.

Authors:  Christine Radtke; Martin Panzica; Khaled Dastagir; Christian Krettek; Peter M Vogt
Journal:  Front Oncol       Date:  2016-01-13       Impact factor: 6.244

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