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Outcomes of Sarcoma Resections Requiring Vascular Surgical Assistance: A Single-Center Experience
- Source :
- Vascular and Endovascular Surgery. 54:579-585
- Publication Year :
- 2020
- Publisher :
- SAGE Publications, 2020.
-
Abstract
- Objective: To describe the types of intervention and determine patency and survival after arterial and venous reconstruction after surgical excision of sarcomas. Methods: Between November 2001 and July 2015, 42 patients with sarcomas and vascular involvement underwent surgical oncologic resection followed by arterial or venous reconstruction or preservation of the native vascular bundle. Univariate, multivariate, and Kaplan-Meier survival analyses were performed on abstracted data, which included demographics, risk factors, oncologic and vascular treatment modalities, postoperative complications, graft patency, and survival outcomes. Results: A total of 42 sarcomas required vascular assistance for oncologic removal. The majority of sarcomas were malignant fibrous histiocytoma (23.8%), and the most common anatomic location was the retroperitoneum (48%). A total of 12 revascularizations procedures were performed, including 5 arterial, 3 venous, and 2 concomitant arterial and venous. In 32 cases, a vascular surgeon was needed for vessel ligation, repair, or mobilization. The overall 2- and 5-year survival was 77.7% and 26.2%, respectively, with no significant survival difference between patients who underwent revascularization compared to those without revascularization. There was a 100% patency rate in all cases at last follow-up, regardless of the type of vascular reconstruction (median 18 months, range 1-29 months). On multivariate analysis, chronic obstructive pulmonary disease (COPD; P = .002) and positive surgical margins ( P = .003) were associated with decreased survival. Most cases were performed in the last 5 years of the study (n = 27, 64.3%). Conclusions: Vascular reconstruction is feasible after surgical oncologic resection of sarcomas with good mid-term patency and limb preservation. Factors independently associated with mortality included COPD and positive surgical margins.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Limb salvage
030204 cardiovascular system & hematology
Single Center
Risk Assessment
Veins
Pulmonary Disease, Chronic Obstructive
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Risk Factors
Intervention (counseling)
Humans
Medicine
Neoplasm Invasiveness
Vascular Patency
Surgical assistance
Aged
Retrospective Studies
Chicago
business.industry
Margins of Excision
Sarcoma
Arteries
General Medicine
Middle Aged
Limb Salvage
medicine.disease
Surgery
Treatment Outcome
030220 oncology & carcinogenesis
Female
Surgical excision
Cardiology and Cardiovascular Medicine
business
Vascular Surgical Procedures
Subjects
Details
- ISSN :
- 19389116 and 15385744
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Vascular and Endovascular Surgery
- Accession number :
- edsair.doi.dedup.....9ee3af4f08ee9e42c9f2fecefedb9f91