Functional outcome following upper limb soft tissue sarcoma resection with flap reconstruction

Payne, Caroline E.; Hofer, Stefan O. P.; Zhong, Toni; Griffin, Anthony M.; Ferguson, Peter C.; Wunder, Jay S.

doi:10.1016/j.bjps.2013.01.034

Cited by 42 publications

(25 citation statements)

References 20 publications

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“…Some authors found that free-flap reconstruction after soft tissue sarcoma excision at the upper extremity is associated with increased morbidity but better local control ( 48 ). Others found that functional outcome achieved satisfactory levels with both pedicled and free flaps ( 49 ).…”

Section: Reconstructionmentioning

confidence: 99%

Soft Tissue Sarcomas of the Arm – Oncosurgical and Reconstructive Principles within a Multimodal, Interdisciplinary Setting

2016

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Soft tissue sarcomas of the upper extremity represent a severe threat for the patient and a difficult task for the treatment team. Due to the complex anatomy of the arm, most sarcomas involve valuable functional structures. Nonetheless, a large portion of the patients can be treated in a limb-sparing manner, and surgery is the mainstay of local tumor control. This review gives an overview of the disease entities and their epidemiology, on necessary patient work-up, staging, and imaging modalities, as well as the importance of interdisciplinary decision-making. The surgical therapies and principles of tumor excision are outlined, as well as reconstructive options. Furthermore, adjuvant treatments are discussed with a special focus on the various application techniques for radiation therapy. In spite of established treatment algorithms, each case is an individual challenge and individually tailored therapy is required. This aspect is illustrated by presenting three comprehensive cases demonstrating useful strategies. A summary of the relevant literature is given.

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Section: Reconstructionmentioning

confidence: 99%

Soft Tissue Sarcomas of the Arm – Oncosurgical and Reconstructive Principles within a Multimodal, Interdisciplinary Setting

2016

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“…Beyond soft tissue coverage, however, functional extremity restoration is a critical component of the reconstructive plan as muscle–tendon units are frequently resected as part of the oncosurgical ablation. Although there have been studies describing potential benefits of functional restoration, the majority of these reports are in the context of soft tissue coverage alone with only a few discussing the role of tendon reconstruction (Davidge et al, ; Lohman et al, ; Mundinger et al, ; Nelson et al, ; Payne et al, ). Omori et al presented their favorable experience using autologous irradiated tendons for immediate reconstruction after sarcoma resection with unspecified “skin flaps” being used for wound closure (Omori et al, ).…”

Section: Discussionmentioning

confidence: 99%

Optimizing functional upper extremity reconstruction—Simultaneous free anterolateral thigh flap and tendon transfers—A case report

2016

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Composite upper extremity defects involving muscle-tendon units are amongst the most formidable reconstructive challenges and mandate functional restoration in addition to stable soft-tissue coverage. Here, the authors present a case of a composite defect involving the extensor muscle-tendon units of the forearm resulting from surgical resection of a recurrent Merkel cell cancer. Functional restoration was achieved via multiple tendon transfers followed by soft tissue coverage with a free anterolateral thigh (ALT) flap. No donor- or recipient-site complications were encountered and complete flap survival was noted. Following a 6-week period of immobilization, physical therapy and range of motion exercises were initiated. Excellent functional outcome and high patient satisfaction were noted at 8 weeks postoperatively. In summary, simultaneous tendon transfers and microsurgical tissue transfer may provide a potentially superior approach for upper extremity reconstruction in complex composite defects. © 2014 Wiley Periodicals, Inc. Microsurgery 37:71-74, 2017.

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“…Surprisingly additional factors, which may impart worse disease-specific survival and increase the risk of postoperative complications, may not impact the functional outcome. These factors include a radiation-induced sarcoma, [62] need for vascular reconstruction, [46] anatomic location, [59, 63, 64] and use of a free or pedicled flap [63, 65]. …”

Section: Functional Outcomementioning

confidence: 99%

Management of soft-tissue sarcomas; treatment strategies, staging, and outcomes

Ramu

Houdek

Isaac

et al. 2017

SICOT-J

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Soft-tissue sarcomas (STS) are a rare group of malignant tumors which can affect any age group. For the majority of patients who present with a localized STS, treatment involves a multidisciplinary team decision-making approach ultimately relying on surgical resection with or without adjuvant radiation for successful limb salvage. The goals of treatment are to provide the patient with a functional extremity without local tumor relapse. The purpose of this article is to review the treatment of extremity STS, with a focus on staging, treatment options, and outcomes.

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Functional outcome following upper limb soft tissue sarcoma resection with flap reconstruction

Cited by 42 publications

References 20 publications

Soft Tissue Sarcomas of the Arm – Oncosurgical and Reconstructive Principles within a Multimodal, Interdisciplinary Setting

Soft Tissue Sarcomas of the Arm – Oncosurgical and Reconstructive Principles within a Multimodal, Interdisciplinary Setting

Optimizing functional upper extremity reconstruction—Simultaneous free anterolateral thigh flap and tendon transfers—A case report

Management of soft-tissue sarcomas; treatment strategies, staging, and outcomes

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