Surgical treatment for soft tissue sarcoma involving vascular nerves
CAO Shi-cong
JIANG Da-wei
TIAN Qi
WU Ji
YANG Xin
TIAN Zheng
Abstract：Objective To evaluate the surgical treatment of soft tissue sarcoma involving blood vessels and nerves,and to put forward the classification of vascular and nerve involvement.Methods A retrospective analysis was performed on the clinical data of 48 patients with soft tissue sarcomas adjacent to or involving blood vessels and nerves in the First Affiliated Hospital of Xinjiang Medical University from December 2016 to December 2021.All patients were examined by MRI before operation,and patients with complex anatomical structure by local enhanced CT.According to the relationship between the tumor and the blood vessels and nerves,three surgical schemes were made.Type A:The adventitia of the corresponding vessel and nerve was completely stripped off and the trunk was preserved;the angle of the perimeter of the interface between the tumor and the blood vessels and nerves was≥180°.Type B:The angle of the perimeter of the interface between the tumor and the blood vessels and nerves was less than 180°.Type C:The tumor was surgically removed and the vascular nerve membrane was preserved;corresponding blood vessels were replaced by artificial blood vessels or vascular grafts.Results All 48 patients had negative margin(R0)resection,including 7 type A patients(14.6%)with artificial vascular replacement or neuroangiectomy,9 type B patients(18.8%)with vascular epineurium dissection,and 32 type C patients(66.6%)with complete tumor resection and intact vascular nerve structure.The local recurrence rate of type B was 22.2%,while type C 21.9%with no statistical differences in local recurrence-free survival time between type B and type C(P = 0.958).Type B adventitial dissection surgery had no effect on postoperative local recurrence of the disease.Conclusions It is confirmed that the degree of vascular and nerve resection has no significant effect on the local recurrence or survival rate for tumor patients when the angle of the perimeter of the interface between the tumor and the blood vessels and nerves was less than 180°.Therefore,the precise classification of involved vessels and nerves may help to select the appropriate degree of resection without affecting the outcome.
Keywords：Soft tissue neoplasmsSarcomaBlood vesselsPeripheral nerves
Publication Date：2023-12-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 904-910 )