Major blood vessel reconstruction during sarcoma surgery.
OBJECTIVE
To evaluate the outcomes of major vessel reconstruction as part of surgery to remove sarcomas.


METHODS
Retrospective review.


METHODS
Tertiary academic medical center.


METHODS
Fourteen patients (10 female) with retroperitoneal or extremity sarcomas and major blood vessel involvement who underwent surgery to remove the tumor and had blood vessel reconstruction between 2003 and 2008. Each patient underwent computed tomography angiography.


METHODS
Early (<30 days) and late (>30 days) operative morbidity and mortality, freedom from disease, and graft patency.


RESULTS
Seven patients had retroperitoneal sarcomas and 7, extremity sarcomas. Thirteen tumors were malignant (7 high grade and 6 low grade) and 1, benign (leiomyoma). Seven patients had replacement of artery and vein; 5, artery only; and 2, vein only. In all, 16 arteries were reconstructed (2 common femoral; 5 iliac; 2 superficial femoral; 1 brachial; 1 popliteal; and 2 aorta, one with implantation of both iliac arteries and the other with implantation of the left renal, superior mesenteric, and hepatic arteries). Eight patients (57%) had 9 veins reconstructed (3 external iliac, 3 superficial femoral, 2 vena cava, and 1 popliteal). Primary arterial patency was 58% and primary-assisted patency was 83%. Venous patency was 78%. Local recurrence occurred in 3 patients (21%). Five-year disease-free and overall survival were 52% and 68%, respectively. Limb salvage was achieved in 93%.


CONCLUSIONS
Involvement of vascular structures is not a contraindication for resection of sarcomas, but appropriate planning is necessary to optimize outcome.
Song
Tae K
TK
Division of Vascular Surgery, Department of Surgery, Stanford University, Stanford, CA 94305-5642, USA.
Harris
E John
EJ
Raghavan
Shyam
S
Norton
Jeffrey A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012509:Sarcoma / Q000556:secondary / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000556:secondary / Q000601:surgery*; D014656:Vascular Surgical Procedures; D055815:Young Adult