MRI as a screening imaging modality for early tumor detection

It is not certain in the revised literature as to consider major vessel infiltration in extremity soft tissue sarcomas, constitutes an indication for amputation. This prospective study included fifteen patients with lower limb soft tissue sarcomas with main vessels invasion. They underwent radical resection and restoration of blood flow as the cornerstone step of limb preservation. Purpose: To review the impact of vascular graft replacement following "radical" resection of Soft Tissue Sarcoma (STS) invading major lower limb vasculature on short term outcomes as regard limb-salvage rate. Methods: Between December 2014 and January 2018, 22 consecutive patients with STS of the lower limb with vascular invasion were investigated, operated and followed up in the Vascular Surgery Department, Mansoura University Hospitals and were followed up for a period that ranged from 3-36 months with mean of 13 months, and a life table analysis was constructed for patency of arterial grafts and for the limb salvage rate. Results: Out of the total (n=22), only 15 patients (12 males and 3 females) aged between 16-57 years had vascular replacement grafts (11 ePTFE, 2 saphenous vein grafts) for arterial reconstruction and 3 replacement grafts (2 ePTFE, 1 saphenous vein graft) for venous reconstruction. Life table analysis for arterial reconstruction showed primary patency rate of 73.85% at 10 months and 64.6% at the end of study with limb salvage rate of 86.7% at last follow up visit. Conclusion: Malignant vascular infiltration should not be a barrier for radical resection for STS patients despite malignant vascular invasion and patients can avoid amputation after careful selection of patients.