Surgery with vascular reconstruction for soft-tissue sarcomas in the inguinal region: oncologic and functional outcomes.
BACKGROUND
Treatment of soft-tissue sarcomas involving the inguinal region remains challenging because of difficulties in achieving wide surgical margins due to anatomical features. The study aimed to analyze the oncologic and functional outcomes of wide resection with vascular reconstruction for inguinal soft-tissue sarcomas.


METHODS
Three men and seven women were treated for inguinal soft-tissue sarcomas by wide surgical resection with vascular reconstruction.


RESULTS
Arteries and veins were replaced in nine patients, and artery replacement alone was carried out in one patient. Femoral nerve resections were performed in six patients. One patient and five patients developed local recurrence and distant metastases, respectively. Limb salvage was achieved in 9 of 10 patients (90%). Six patients and one patient developed vascular (arterial graft occlusion [n = 1], lymphedema [n = 5]) and nonvascular (hematoma [n = 1]) complications, respectively. Five-year arterial primary patency was 77%. Five-year disease-free and overall survival rates were 45% and 77%, respectively. Functional outcome scores at latest follow-up averaged 87.5% for Musculoskeletal Tumor Society 1993.


CONCLUSIONS
En-bloc resection of major critical structures along with tumor and vascular reconstructions using synthetic grafts is a feasible option in limb salvage surgery for inguinal soft-tissue sarcomas.
Musculoskeletal Oncology Service, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. emrmkt@yahoo.co.jp
Makoto
M
Emori
Kenichiro
K
Hamada
Shinsuke
S
Omori
Susumu
S
Joyama
Yasuhiko
Y
Tomita
Nobuyuki
N
Hashimoto
Hiroshi
H
Takami
Norifumi
N
Naka
Hideki
H
Yoshikawa
Nobuhito
N
Araki
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005263:Femoral Artery / Q000473:pathology / Q000601:surgery; D005268:Femoral Vein / Q000473:pathology / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000473:pathology / Q000601:surgery; D007084:Iliac Vein / Q000473:pathology / Q000601:surgery; D007564:Japan; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000401:mortality; D012086:Reoperation; D012509:Sarcoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D055815:Young Adult