TECHNICAL ASPECTS AND SURGICAL STRATEGY F OR VESSEL-INVADING TUMORS OF THE SOFT-TISSUE

Patients suffering from soft tissue sarcoma of the extremities may som etimes require vascular reconstruction to remove the tumor with adequa te margins of clearance. Besides this, recurrent lymph node metastases are often affixed to neighboring vessels. MRI and angiography represe nt the adequate diagnostic procedures. Vessel-invasive sarcoma can har dly be treated by surgical resection with curative intent alone. If th ere is doubt about invasion of arteries and veins, the vessels should be resected and replaced by autologous vein graft. Soft tissue coverag e is of major importance, particularly if prosthetic grafts are used o r the resection is within an area of irradiated tissue. After radical resection and combined modality therapy, one can expect local recurren ce rates similar to those without vessel invasion. To achieve this goa l, surgical oncologists, vascular surgeons and plastic surgeons must w ork together. Today, amputation can hardly be justified even in vessel -invasive soft tissue tumors.