Oncosurgical and reconstructive concepts in the treatment of soft tissue sarcomas: a retrospective analysis.
BACKGROUND
Patients with soft tissue sarcomas are initially treated in community hospitals and in the private practice setting in the majority of cases. Thus, this disease entity is initially treated by surgeons with limited experience and expertise regarding the complex and demanding therapeutic regimen necessary to address this distinct group of malignancies.


METHODS
A retrospective analysis was conducted with a particular focus on factors affecting patient outcome, oncosurgical intervention, and plastic surgical reconstruction.


RESULTS
A total of 75 patients were included in the study. Only 66% of all patients presented with a primary tumor. The remaining 34% presented with either local recurrence or distant metastasis. The oncosurgical procedure most commonly performed was wide excision (69%). However, amputation was unavoidable in 7% of cases. Single-step reconstruction included primary closure (19%), skin grafting (19%), local fascio- or myocutaneous flap transfer (31%), as well as free flap transfer (31%). 17 patients (20%) have deceased due to their underlying disease. Yet another 10% are alive with evidence of residual tumor. Kaplan-Meier analysis displayed significant differences in overall survival rate depending on disease stage upon initial presentation.


CONCLUSIONS
Based on our data favorable oncological outcomes with satisfactory functional results and limb preservation are achievable if oncological principles for resection are respected and reconstruction is performed according to plastic surgical principles.
Bannasch
Holger
H
Department of Plastic and Hand Surgery, University Medical Center Freiburg (UMCF), Hugstetter Strasse 55, 79106, Freiburg, Germany. holger.bannasch@uniklinik-freiburg.de
Haivas
Irina
I
Momeni
Arash
A
Stark
G Björn
GB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D055815:Young Adult