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Interdisciplinary Surgical Therapy of Extremity Soft-Tissue Sarcomas: A Personalized Resection and Reconstruction Algorithm

Soft-tissue sarcomas (STS) are rare, but potentially life-threatening malignancies. STS can occur anywhere in the human body with the limbs being the most common site. Referral to a specialized sarcoma center is crucial to guarantee prompt and appropriate treatment. STS treatment strategies should b...

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Autores principales: Osterloh, Justus, Ludolph, Ingo, Grützmann, Robert, Meyer, Alexander, Lang, Werner, Horch, Raymund E., Fechner, Katja, Arkudas, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965817/
https://www.ncbi.nlm.nih.gov/pubmed/36836496
http://dx.doi.org/10.3390/jpm13020262
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author Osterloh, Justus
Ludolph, Ingo
Grützmann, Robert
Meyer, Alexander
Lang, Werner
Horch, Raymund E.
Fechner, Katja
Arkudas, Andreas
author_facet Osterloh, Justus
Ludolph, Ingo
Grützmann, Robert
Meyer, Alexander
Lang, Werner
Horch, Raymund E.
Fechner, Katja
Arkudas, Andreas
author_sort Osterloh, Justus
collection PubMed
description Soft-tissue sarcomas (STS) are rare, but potentially life-threatening malignancies. STS can occur anywhere in the human body with the limbs being the most common site. Referral to a specialized sarcoma center is crucial to guarantee prompt and appropriate treatment. STS treatment strategies should be discussed in an interdisciplinary tumor board to involve expertise from all available resources, including an experienced reconstructive surgeon for an optimal outcome. In many cases, extensive resection is needed to achieve R0 resection, resulting in large defects after surgery. Hence, an evaluation of whether plastic reconstruction might be required is mandatory to avoid complications due to insufficient primary wound closure. In this retrospective observational study, we present data of patients with extremity STS treated at the Sarcoma Center, University Hospital Erlangen, in 2021. We found that complications were more frequent in patients who received secondary flap reconstruction after insufficient primary wound closure compared to patients who received primary flap reconstruction. Additionally, we propose an algorithm for an interdisciplinary surgical therapy of soft-tissue sarcomas regarding resection and reconstruction and present two problematic cases to emphasize the complexity of surgical sarcoma therapy.
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spelling pubmed-99658172023-02-26 Interdisciplinary Surgical Therapy of Extremity Soft-Tissue Sarcomas: A Personalized Resection and Reconstruction Algorithm Osterloh, Justus Ludolph, Ingo Grützmann, Robert Meyer, Alexander Lang, Werner Horch, Raymund E. Fechner, Katja Arkudas, Andreas J Pers Med Article Soft-tissue sarcomas (STS) are rare, but potentially life-threatening malignancies. STS can occur anywhere in the human body with the limbs being the most common site. Referral to a specialized sarcoma center is crucial to guarantee prompt and appropriate treatment. STS treatment strategies should be discussed in an interdisciplinary tumor board to involve expertise from all available resources, including an experienced reconstructive surgeon for an optimal outcome. In many cases, extensive resection is needed to achieve R0 resection, resulting in large defects after surgery. Hence, an evaluation of whether plastic reconstruction might be required is mandatory to avoid complications due to insufficient primary wound closure. In this retrospective observational study, we present data of patients with extremity STS treated at the Sarcoma Center, University Hospital Erlangen, in 2021. We found that complications were more frequent in patients who received secondary flap reconstruction after insufficient primary wound closure compared to patients who received primary flap reconstruction. Additionally, we propose an algorithm for an interdisciplinary surgical therapy of soft-tissue sarcomas regarding resection and reconstruction and present two problematic cases to emphasize the complexity of surgical sarcoma therapy. MDPI 2023-01-30 /pmc/articles/PMC9965817/ /pubmed/36836496 http://dx.doi.org/10.3390/jpm13020262 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Osterloh, Justus
Ludolph, Ingo
Grützmann, Robert
Meyer, Alexander
Lang, Werner
Horch, Raymund E.
Fechner, Katja
Arkudas, Andreas
Interdisciplinary Surgical Therapy of Extremity Soft-Tissue Sarcomas: A Personalized Resection and Reconstruction Algorithm
title Interdisciplinary Surgical Therapy of Extremity Soft-Tissue Sarcomas: A Personalized Resection and Reconstruction Algorithm
title_full Interdisciplinary Surgical Therapy of Extremity Soft-Tissue Sarcomas: A Personalized Resection and Reconstruction Algorithm
title_fullStr Interdisciplinary Surgical Therapy of Extremity Soft-Tissue Sarcomas: A Personalized Resection and Reconstruction Algorithm
title_full_unstemmed Interdisciplinary Surgical Therapy of Extremity Soft-Tissue Sarcomas: A Personalized Resection and Reconstruction Algorithm
title_short Interdisciplinary Surgical Therapy of Extremity Soft-Tissue Sarcomas: A Personalized Resection and Reconstruction Algorithm
title_sort interdisciplinary surgical therapy of extremity soft-tissue sarcomas: a personalized resection and reconstruction algorithm
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965817/
https://www.ncbi.nlm.nih.gov/pubmed/36836496
http://dx.doi.org/10.3390/jpm13020262
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