Sebészi radikalitás és rekonstrukciós lehetőségek végtagi lágyrészsarcomáknál

Abstract

Soft tissue sarcomas are rare, reaching some 1.5% of all malignant tumors. While formerly the surgical management of sarcomas almost exclusively consisted of amputation, in the recent years limb saving surgery has become the first choice of therapy. Negative factors affecting the survival rate are: histologically high-grade tumor, size and localization of the tumor, vascular invasion, extensive tumor necrosis, certain subgroups, local recurrence and oncologically positive surgical margin at the resection. Many modern reconstruction possibilities are essential for the safe limb saving surgery with wide surgical margins, such as bone allograft implantation, tumor endoprostheses reconstruction, vascular grafting and plastic surgery. There should always be an attempt to perform limb saving surgery, however life quality, life expectancy and survival are more important considerations influencing essentially the surgical method of choice. In our follow-up study no significant difference in recurrence rate was found between the group of patients with sarcomas requiring a complex reconstruction procedure and the group of those treated by only resection methods (32% versus 47%).