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World J Clin Cases. Apr 26, 2024; 12(12): 2004-2008
Published online Apr 26, 2024. doi: 10.12998/wjcc.v12.i12.2004
Indication and surgical approach for reconstruction with endoprosthesis in bone-associated soft tissue sarcomas: Appropriate case management is vital
Recep Öztürk
Recep Öztürk, Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen 45143, Germany
Author contributions: Öztürk R contributed to the literature review, wrote the manuscript, read and approved the final manuscript.
Conflict-of-interest statement: The author states that there is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Recep Öztürk, MD, Associate Professor, Researcher, Surgeon, Surgical Oncologist, Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Hufelandstraße 55, Essen 45143, Germany. ozturk_recep@windowslive.com
Received: November 15, 2023
Peer-review started: November 15, 2023
First decision: January 9, 2024
Revised: February 9, 2024
Accepted: March 26, 2024
Article in press: March 26, 2024
Published online: April 26, 2024

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.