Vascular reconstruction in lower limb musculoskeletal tumours.
BACKGROUND
Individual experience in the investigative, planning and operative aspects of lower limb musculoskeletal tumours is often small, making comparison between results difficult. The aim of the study was to describe the recent experience of a single tertiary referral unit performing limb salvage surgery, to identify areas of concern that are amenable to intervention and to provide clinicians an understanding of the surgical options.


METHODS
Nine patients with peripheral limb musculoskeletal tumours are described. Four patients had a leiomyosarcoma, and one each of osteosarcoma, synovial chondrosarcoma, synovial sarcoma, liposarcoma and recurrent malignant peripheral nerve sheath tumour.


RESULTS
Thirty-day mortality was nil. Two patients (one with a leiomyosarcoma and one with an osteosarcoma) died at 6 months follow-up because of pulmonary metastases. One patient with synovial chondrosarcoma developed a local recurrence and underwent an above-knee amputation. Six patients at 18 months follow-up are alive with no evidence of local recurrence and a functional lower limb.


CONCLUSIONS
These cases are a challenge to the clinicians, radiologists and pathologists. Review by a multidisciplinary team can produce successful results with low post-operative morbidity and mortality. Longer follow-up is required to determine the long-term implications.
Spark
J Ian
JI
Department of Vascular Surgery, Flinders Medical Centre and Repatriation General Hospital, Bedford Park, Adelaide, South Australia 5042, Australia. ian.spark@health.sa.gov.au
Charalabidis
Peter
P
Laws
Peter
P
Seben
Ruben
R
Clayer
Mark
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000473:pathology / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D012501:Saphenous Vein / Q000637:transplantation; D055815:Young Adult