Major vessel resection during limb-preserving surgery for soft tissue sarcomas.

Abstract

There is uncertainty in the literature as to whether major vessel involvement in extremity soft tissue sarcomas constitutes an indication for amputation. This retrospective review includes 21 patients who underwent major vessel resection in the context of limb preservation for soft tissue sarcomas. Resected vessels were the common iliac in one, external iliac and common femoral in six, common and superficial femoral in five, superficial femoral in six, distal superficial and popliteal in two, and subclavian vessels in one. Wound infection occurred postoperatively in five patients (24%). One Gore-tex and one vein graft became exposed, but the wounds healed by secondary intention with routine wound care. Three patients (14%) manifested local recurrence, of which one required an amputation. The estimated 5-year survival rate is 63%. Involvement of major vessel(s) by soft tissue sarcomas of the extremities is not in itself an indication for amputation, as with en bloc resection of major vessels the local recurrence and 5-year survival rates parallel those of patients with soft tissue sarcomas not requiring major vessel resection.