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Online ISSN 1827-1707
Boffano M. 1, Gino G. 1, Stella M. 2, Battiston B. 3, Tos P. 3, Capocelli R. 2, Bollero D. 2, Albertini U. 1, Piana R. 1, Linari A. 4, Mosetto F. 1, Sacco F. 1, Comandone A. 5, Brach Del Prever E. M. 1
1 Dipartimento di Ortopedia e Traumatologia Unità Operativa Dipartimentale di Chirurgia Ortopedica Oncologica e Ricostruttiva
ASO CTO, CRF, MA, Torino
2 Struttura Complessa di Chirurgia Plastica-Ricostruttiva e Grandi Ustionati ASO CTO, CRF,MA, Torino
3 Dipartimento di Ortopedia e Traumatologia Unità Operativa Dipartimentale di Microchirurgia Ricostruttiva ASO CTO, CRF,MA, Torino
4 Servizio di Anatomia Patologica ASO OIRM Ospedale S. Anna, Torino
5 SCDO Oncologia Medica Ospedale Gradenigo, Torino
Aim. Resection with radical or wide margins of soft tissue sarcomas must be followed by reconstructive treatments in reference centre.
Aim of the study was to evaluate clinical and functional result of limb soft tissue sarcomas treated with plastic surgery and microsurgical techniques in an Italian regional reference centre.
Methods. Among the 123 sarcomas treated at the Departmental Unit of Orthopaedic-Oncological and Reconstructive Surgery of ASO CTO-CRF-MA in Turin from January 2001 to June 2005, limb salvage was possible in 104 patients: 30 of them with reconstructive treatments after resection with wide margins (22 cases), marginal (7 cases), intralesional (1 case): 3 free flaps, 18 pedicle flaps, 9 dermoepidermic grafts. At mean follow up of 20 months, wound healing, local recurrences and progressions, delay of adjuvant treatments, Mankin’s functionality and oncologic follow-up were analyzed.
Results. Local recovery was obtained in all cases. 5 local recurrences and 7 progressions occured; 6 patients had adjuvant treatments without any delay. Functional result was Excellent in 8 cases, Good in 8 cases, Fair in 2 cases, Failure in 12 cases. Follow up outcomes: 17 patients with no evidence of disease, 6 with disease, 5 dead of disease, 1 dead of second neoplasm, 1 lost at follow up after one year.
Conclusion. Microsurgical techniques and plastic surgery allow to perform en bloc oncological resections with wide margins and limb salvage without worsening survival rate but increasing quality of life. Multidisciplinary approach is mandatory.