scholarly journals Management of Lower Limb Soft Tissue Sarcomas with Major Neurovascular Involvement: Current and Future Perspectives

EMJ Oncology ◽  
2021 ◽  
pp. 91-99
Author(s):  
Noor Tamimi ◽  
Hussein Sweiti
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Functional Outcomes ◽  
Multidisciplinary Approach ◽  
Treatment Algorithm ◽  
Soft Tissue Sarcomas ◽  
Classification Systems ◽  
Appropriate Treatment ◽  
Neurovascular Structures ◽  
Mesenchymal Tumours

Lower limb soft tissue sarcomas are a group of rare mesenchymal tumours that may grow in close anatomical proximity to major neurovascular structures, leading to significant oncological and surgical challenges for treating physicians. This article reviews the current literature on the multidisciplinary approach of treating lower limb soft tissue sarcomas with neurovascular involvement and describes the increasing shift towards limb-sparing surgeries, with an emphasis on improved functional outcomes based on a multimodal treatment approach. In addition to identifying the histological subtype of the tumour, classifying the neurovascular involvement precisely is key in planning the appropriate treatment. Existing classification systems for both vascular and neural involvement are discussed, and a combined neurovascular classification is proposed together with a general treatment algorithm.

scholarly journals PC142. Multidisciplinary Approach to Treatment of Soft Tissue Sarcomas Requiring Complex Oncologic Resections

2015 ◽  
Vol 61 (6) ◽  
pp. 156S
Author(s):  
Nadia A. Awad ◽  
Richard Lackman ◽  
Tae Won B. Kim ◽  
Joseph V. Lombardi ◽  
Francis J. Caputo
Keyword(s):  
Soft Tissue ◽  
Multidisciplinary Approach ◽  
Soft Tissue Sarcomas

Soft Tissue Sarcoma – a Current Review of the Diagnostic and Treatment Strategies

2019 ◽  
Vol 157 (06) ◽  
pp. 644-653 ◽  
Author(s):  
Sebastian Scheidt ◽  
Cornelius Jacobs ◽  
Sebastian Koob ◽  
Kristian Welle ◽  
Sebastian Walter ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Treatment Algorithm ◽  
Treatment Strategies ◽  
Soft Tissue Sarcomas ◽  
Current Evidence ◽  
Delayed Treatment ◽  
Current Review ◽  
Soft Tissue Swelling ◽  
A Current

AbstractSoft tissue sarcomas are a heterogeneous group of neoplasias that due to their often clinically silent appearance often remain undetected or experience delayed treatment. Especially soft tissue swelling is often misinterpreted by patients and doctors and trivialized or verified with an incorrect biopsy technique. The hereby evoked complications for the patients are serious and may be reduced by simply following the available guidelines. The treatment of soft tissue sarcomas requires a close interdisciplinary coordination between specialists in tumor orthopedics, oncology, radiology, pathology and radiotherapy. On the basis of a selective literature review, the following article points out the current evidence on the treatment and illustrates a treatment algorithm.

scholarly journals Incidence and Severity of Lymphoedema following Limb Salvage of Extremity Soft Tissue Sarcoma

Sarcoma ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Daniel Friedmann ◽  
Jay S. Wunder ◽  
Peter Ferguson ◽  
Brian O'Sullivan ◽  
David Roberge ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Limb Salvage ◽  
Functional Outcomes ◽  
Soft Tissue Sarcomas ◽  
Treatment Modalities ◽  
Adjuvant Radiation ◽  
Tumor Characteristics ◽  
Msts Score ◽  
Extremity Soft Tissue Sarcoma ◽  
Associated Risk Factors

Background and Purpose. Lymphoedema is a serious complication following limb salvage for extremity soft tissue sarcomas (STSs) for which little is known. We aimed to evaluate its incidence, its, severity and its associated risk factors.Material and Method. Patient and tumor characteristics, treatment modalities and complications and functional outcomes (MSTS 1987, TESS), and lymphoedema severity (Stern) were all collected from prospective databases. Charts were retrospectively abstracted for BMI and comorbidities.Results. There were 289 patients (158 males). Mean age was 53 (16–88). Followup ranged between 12 and 60 months with an average of 35 and a median of 36 months. Mean BMI was 27.4 (15.8–52.1). 72% had lower extremity tumors and 38% upper extremity. Mean tumor size was 8.1 cm (1.0–35.6 cm). 27% had no adjuvant radiation, 62% had 50 Gy, and 11% received 66 Gy. The incidence of lymphoedema was 28.8% (206 none, 58 mild, 22 moderate, 3 severe, and 0 very severe). Mean MSTS score was 32 (11–35) and TESS was 89.4 (32.4–100). Radiation dose was significantly correlated with tumorsize>5 cm (P=0.0001) and TESS score (P=0.001), but not MSTS score (P=0.090). Only tumorsize>5 cm and depth were found to be independent predictors of significant lymphoedema.Conclusion. Nine percent of STS patients in our cohort developed significant (grade≥2) lymphoedema. Tumorsize>5 cm and deep tumors were associated with an increased occurrence of lymphoedema but not radiation dosage.

Multidisciplinary Approach to Treatment of Soft Tissue Sarcomas Requiring Complex Oncologic Resections

2018 ◽  
Vol 53 ◽  
pp. 212-216 ◽  
Author(s):  
Nadia Awad ◽  
Richard Lackman ◽  
Katherine McMackin ◽  
Tae Won Kim ◽  
Joseph Lombardi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Multidisciplinary Approach ◽  
Soft Tissue Sarcomas

scholarly journals Reconstructive Treatment following Resection of High-Grade Soft-Tissue Sarcomas of the Lower Limb

2005 ◽  
Vol 13 (1) ◽  
pp. 58-63 ◽  
Author(s):  
AM Leow ◽  
AS Halim ◽  
Z Wan
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Soft Tissue Sarcomas ◽  
Free Tissue Transfer ◽  
Rectus Abdominis ◽  
Lower Limbs ◽  
High Grade ◽  
Rectus Abdominis Flap ◽  
Tissue Transfer ◽  
Fibula Flap

Purpose. To review the role of free tissue transfer in reconstructive surgery following resection of high-grade soft-tissue sarcomas of the lower limb. Methods. Medical records of all consecutive patients with high-grade soft-tissue sarcomas of the lower limbs between August 1997 and September 2003 were reviewed. Results. Of 8 patients (6 women and 2 men) aged between 19 and 65 years, 4 had malignant fibrous histiocytoma, one had malignant peripheral nerve sheath tumour, one had synovial sarcoma, one had recurrent liposarcoma, and one had epitheloid sarcoma. The tumour sizes ranged from 132 cm2 to 483 cm2. The soft-tissue defects following tumour extirpation ranged from 153 cm2 to 896 cm2. The flaps used were 3 free latissimus dorsi flaps, 2 free osteoseptocutaneous fibula flaps (one vascularised fibula flap and one ‘double barrel’ fibula flap), one free rectus abdominis flap, 2 free mini-transverse rectus abdominis flaps, and one pedicled rectus abdominis flap. Five patients did not have local recurrence and systemic metastases. Conclusion. Tissue transfer allows early adjuvant therapy facilitating the multimodal approach for the high-grade soft-tissue sarcomas of the lower extremity.

scholarly journals Lymph Node Metastasis after a Soft Tissue Sarcoma of the Leg: A Case Report and a Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
S. D. Nelen ◽  
F. J. Vogelaar ◽  
F. Gilissen ◽  
J. C. Van der Linden ◽  
K. Bosscha
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Lower Extremity ◽  
Distant Metastasis ◽  
Soft Tissue Sarcomas ◽  
Dermatofibrosarcoma Protuberans ◽  
Regional Lymph Nodes ◽  
Histological Types ◽  
Appropriate Treatment

Introduction. Soft tissue sarcomas (STSs) represent 1 percent of all adult malignancies and sarcomas only rarely spread to the regional lymph nodes.Case Presentation. We present a case of a woman with a dermatofibrosarcoma protuberans and a sarcoma not therwise specified of the lower extremity. The patient had no distant metastasis during follow-up, but did develop a regional lymph nodemetastasis (RLNM) in the groin. We reviewed the literature about RLNM in STSs.Discussion. Reviewing the literature we see that within specific histological types RLNM occurs as often as distant metastasis. Furthermore RLNM occurs in over 10% for specific histological types and in 24% of all patients with a soft tissue sarcoma of the lower extremity. Except for radical lymphadenectomy with a 5-year survival rate of 46% there is no appropriate treatment.Conclusion. The risk for a RLNM in certain histological types and anatomical locations might transcend the risk for a distant lung metastasis.

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