Article
Indications and clinical outcome in patients with soft-tissue sarcoma receiving prosthetic replacement after tumor resection
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Authors
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Nina Myline Engel
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
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Arne Streitbürger
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
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Jendrik Hardes
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
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Wiebke Guder
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
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Lars E. Podleska
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
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Markus Nottrott
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
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Recep Öztürk
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
| Published: | October 21, 2024 |
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Outline
Text
Objectives: Bone resection and endoprosthetic reconstruction (EPR) applications in the treatment of soft tissue sarcoma (STS) are rare, and present with unique challenges. This study aimed to analyze the indications, results and factors affecting the results of these cases.
Methods: Twelve patients (5 women, median age 49 years) who underwent endoprosthetic reconstruction due to soft tissue sarcoma between 2010 and 2021 were analyzed retrospectively. While the most common localization was the thigh (66%), the most common diagnosis was myxofibrosarcoma (33%). Indications were; the close relationship of the tumor with the bone (n = 6), suspicious bone infiltration on Magnetic Resonance Imaging (n = 5), and the presence of an intra-articular tumor with a history of arthroscopic biopsy (n = 1). A total of 3 patients had a history of R1 resection. The most common proximal femoral endoprosthesis (33%) was applied. Two patients were amputated during follow-up.
Results and conclusion: Eight patients (66%) had no evidence of disease at the last follow-up examination (median 62 months), while 4 patients died in an average of 14 months. The fact that the tumor was located in the thigh, the presence of metastasis at the time of diagnosis, a history of R1 resection, the diagnosis being myxofibrosarcoma, the presence of bone infiltration, CT (Chemotherapy)+ILP(Isolated limb Perfusion) treatment and in-domo biopsy did not significantly affect the recurrence and survival of the patient. A history of R1 resection was significantly negative prognostic in terms of prosthesis survival (p<0.045).
In bone-associated soft tissue sarcomas, wide resection and endoprosthetic reconstruction is a recommendable option with good oncological results and acceptale complication rate. The most common indication is close relationship of the tumor to the bone. The presence of bone infiltration does not increase the risk of local recurrence. Unplanned intralesional interventions significantly reduce limb survival.
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