Indication and surgical approach for reconstruction with endoprosthesis in bone-associated soft tissue sarcomas: Appropriate case management is vital

Abstract

It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas (STS) have unique features in terms of indication, surgical approach and follow-up, in terms of the management of these cases. Some STS are associated with bone and major neurovascular structures. Bone-associated STS are generally relatively large and relatively deep-seated. Additionally, the tendency for metastasis is high. In some cases, the decision about which structures to resect is difficult. These cases are often accompanied by poor oncological and surgical outcomes. Management of cases should be done by a multidisciplinary team in advanced centers specialized in this field. The surgical team must have sufficient knowledge and experience in the field of limb-sparing surgery. Preoperative evaluation and especially good planning of bone and soft tissue reconstruction are vital.

Keywords: Soft tissue sarcoma; Bone invasion; Bone resection; Endoprosthesis replacement; Prosthesis; Limb salvage; Indication; Approach

Core Tip: In soft tissue sarcomas with bone invasion, resection of the tumor with wide margins including the relevant bone segment and endoprosthesis applications continue to be the recommended treatment method with satisfactory results. Preoperative evaluation and planning before surgery is crucial. In cases where there is a dilemma in surgical procedures, the decision of whether to perform bone resection affects the fate of the case. Bone and soft tissue reconstruction, especially after resection, should be planned meticulously to ensure adequate soft tissue coverage.