PECULIAR FEATURES OF SURGERIES IN SOFT-TISSUE SARCOMAS OF THE EXTREMITIES IN CHILDREN

Cover Page


Cite item

Full Text

Abstract

Based on the data obtained during foreign studies, the article analyses the approaches and recommendations related to the safe and necessary resection width of soft-tissue sarcomas. Currently, there are no distinct criteria that can help a surgeon to evaluate the proper volume of resected tissue in a minimum risk of a local recurrence and provide for an adequate functional result considering the subsequent reconstructive and plastic methods.

About the authors

K. S. Tsilenko

Dmitry Rogachyov Medical Research Center for Pediatric Hematology, Oncology and Immunology of the Ministry of Health of Russia

Author for correspondence.
Email: 2408062@mail.ru

ЦИЛЕНКО Константин Сергеевич – младший научный сотрудник, врач – детский хирург 

Москва

Russian Federation

M. S. Kubirov

Morozov Children’s State Clinical Hospital of the Ministry of Health of Moscow

Email: fake@neicon.ru

КУБИРОВ Максим Сергеевич – кандидат медицинских наук, врач-онколог, заведующий отделением клинической онкологии 

Москва

Russian Federation

D. M. Konovalov

Dmitry Rogachyov Medical Research Center for Pediatric Hematology, Oncology and Immunology of the Ministry of Health of Russia

Email: fake@neicon.ru

КОНОВАЛОВ Дмитрий Михайлович – кандидат медицинских наук, заведующий патолого-анатомическим отделением 

Москва

Russian Federation

References

  1. Ring A., Kirchhoff P., Goertz O. et al. Reconstruction of Soft-Tissue Defects at the Foot and Ankle after Oncological Resection.Front Surg 2016;3:15.
  2. Pappo A. S., Pratt C. B. Soft tissue sarcomas in children. Cancer Treat Res 1997;205:22.
  3. Ries L. A., Smith M. A., Gurney J. G. et al. Cancer incidence and survival among children and adolescents: United States SEER Program 1975–1995. Bethesda, Md: National Cancer Institute, SEER Program, 1999. NIH Pub. No. 99–4649.
  4. Spunt S. L., Million L., Coffin C. The nonrhabdomyosarcoma soft tissue sarcoma.Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams and Wilkins 2015;827:54.
  5. Weiss S. W., Goldblum J. R. General considerations. Enzinger and Weiss’s Soft Tissue Tumors. 5th ed. St. Louis, Mo: Mosby 2008;1:14.
  6. Dillon P., Maurer H., Jenkins J. et al. A prospective study of nonrhabdomyosarcoma soft tissue sarcomas in the pediatric age group. J PediatrSurg 1992;241:4.
  7. Rao B. N. Nonrhabdomyosarcoma in children: prognostic factors influencing survival. SeminSurgOncol 1993;524:31.
  8. Zeytoonjian T., Mankin H. J., Gebhardt M. C. et al. Distal lower extremity sarcomas: frequency of occurrence and patient survival rate. Foot Ankle 2004;325:30.
  9. Benesch M., Bueren A. O., Dantonello T. et al. Primary intracranial soft tissue sarcoma in children and adolescents: a cooperative analysis of the European CWS and HIT study groups. J Neurooncol 2013;337:45.
  10. Weiss S. W., Goldblum J. R. Miscellaneous tumors of intermediate malignancy. Enzinger and Weiss’s Soft Tissue Tumors. 5th ed. St. Louis, Mo: Mosby 2008;1093:1160.
  11. Weiss S. W., Goldblum J. R. Enzinger and Weiss’s Soft Tissue Tumors. 4th ed. St. Louis, Mo: Mosby 2001.
  12. Recommendations for the reporting of soft tissue sarcomas. Association of Directors of Anatomic and Surgical Pathology. Mod Pathol 1998;1257:61.
  13. Chowdhury T., Barnacle A., Haque S. et al. Ultrasound-guided core needle biopsy for the diagnosis of rhabdomyosarcoma in childhood. Pediatr Blood Cancer 2009;356:60.
  14. Coffin C. M., Dehner L. P., O’Shea P. A. Pediatric Soft Tissue Tumors: A Clinical, Pathological, and Therapeutic Approach. Baltimore, Md: Williams and Wilkins, 1997.
  15. Smith L. M., Watterson J., Scott S. M. Pediatric Soft Tissue Tumors: A Clinical, Pathological, and Therapeutic Approach. Baltimore, Md: Williams and Wilkins 1997;360:71.
  16. Stoeckle E., Coindre J. M., Bonvalot S. et al. Prognostic factors in retroperitoneal sarcoma: a multivariate analysis of a series of 165 patients of the French Cancer Center Federation Sarcoma Group. Cancer 2001;92:359.
  17. Lewis J. J., Leung D., Woodruff J. M., Brennan M. F. Retroperitoneal softtissue sarcoma: analysis of 500 patients treated and followed at a single institution. Ann Surg 1998;228:355.
  18. Storm F. K., Mahvi D. M. Diagnosis and management of retroperitoneal softtissue sarcoma. Ann Surg 1991;214:2.
  19. Hassan I., Park S. Z., Donohue J. H. et al. Operative management of primary retroperitoneal sarcomas: a reappraisal of an institutional experience. Ann Surg 2004;239:244.
  20. Catton C. N., O’Sullivan B., Kotwall C. et al. Outcome and prognosis in retroperitoneal soft tissue sarcoma. Int J RadiatOncolBiolPhys 1994;29:1005.
  21. Lehnert T., Cardona S., Hinz U. et al. Primary and locally recurrent retroperitoneal softtissue sarcoma: local control and survival. Eur J SurgOncol 2009;35:986.
  22. Anaya D. A., Lev D. C., Pollock R. E. The role of surgical margin status in retroperitoneal sarcoma. J SurgOncol 2008;98:607.
  23. Pierie J. P., Betensky R. A., Choudry U. et al. Outcomes in a series of 103 retroperitoneal sarcomas. Eur J SurgOncol 2006;32:1235.
  24. Avances C., Mottet N., Mahatmat A. et al. Prognostic factors for first recurrence in patients with retroperitoneal sarcoma. UrolOncol 2006;24:94.
  25. Stoeckle E., Italiano A., Stock N., Kind M., Kantor G., Coindre J. M., Bui B. N. Surgical margins in soft tissue sarcoma. Bull Cancer 2008;95:12.
  26. Chui C. H., Spunt S. L., Liu T. et al. Isreexcision in pediatricnonrhabdomyosarcoma soft tissue sarcoma necessary after an initial unplanned resection? J PediatrSurg 2002;1424:9.
  27. Cecchetto G., Guglielmi M., Inserra A. et al. Primary re-excision: the Italian experience in patients with localized softtissue sarcomas. PediatrSurgInt 2001;532:4.
  28. Qureshi Y. A., Huddy J. R., Miller J. D. et al. Unplanned excision of soft tissue sarcoma results in increased rates of local recurrence despite full further oncological treatment. Ann SurgOncol 2012;871:7.
  29. Spunt S. L., Hill D. A., Motosue A. M. et al. Clinical features and outcome of initially unresectednonmetastaticpediatricno nrhabdomyosarcoma soft tissue sarcoma. J ClinOncol 2002;3225:35.
  30. O’Sullivan B., Davis A. M., Turcotte R. et al. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. Lancet 2002;2235:41.
  31. Ferrari A., Miceli R., Rey A. et al. Non-metastatic unresected paediatric non-rhabdomyosarcoma soft tissue sarcomas: results of a pooled analysis from United States and European groups. Eur J Cancer 2011;724:31.
  32. Smith K. B., Indelicato D. J., Knapik J. A. et al. Definitive radiotherapy for unresectablepediatric and young adult nonrhabdomyosarcoma soft tissue sarcoma. Pediatr Blood Cancer 2011;247:51.
  33. Dillon P. W., Whalen T. V., Azizkhan R. G. et al. Neonatal soft tissue sarcomas: the influence of pathology on treatment and survival. Children’s Cancer Group Surgical Committee. J PediatrSurg 1995;1038:41.
  34. Pappo A. S., Fontanesi J., Luo X. et al. Synovial sarcoma in children and adolescents: the St Jude Children’s Research Hospital experience. J ClinOncol 1994;2360:6.
  35. Marcus K. C., Grier H. E., Shamberger R. C. et al. Childhood soft tissue sarcoma: a 20-year experience. J Pediatr 1997;603:7.
  36. Pratt C. B., Pappo A. S., Gieser P. et al. Role of adjuvant chemotherapy in the treatment of surgically resected pediatricno nrhabdomyosarcomatous soft tissue sarcomas: A Pediatric Oncology Group Study. J ClinOncol 1999;4:1219.
  37. Pratt C. B., Maurer H. M., Gieser P. et al. Treatment of unresectable or metastatic pediatric soft tissue sarcomas with surgery, irradiation, and chemotherapy: a Pediatric Oncology Group study. Med PediatrOncol 1998;201:9.
  38. Tanabe K. K., Pollock R. E., Ellis L. M. et al. Influence of surgical margins on outcome in patients with preoperatively irradiated extremity soft tissue sarcomas. Cancer 1994;73:1652.
  39. Kandel R., Coakley N., Werier J. et al. Surgical margins and handling of soft-tissue sarcoma in extremities: a clinical practice guideline. CurrOncol 2013;20 (3):247–54.
  40. Steinau H. U., Steinstrasser L., Hauser J. et al. Softtissuesarcoma. Resection and plastic reconstruction. Orthopade 2012;41 (2):165–75.
  41. Brooks A. D., Gold J. S., Graham D. et al. Resection of the sciatic, peroneal, or tibial nerves: assessment of functional status. Ann SurgOncol 2002;9:41.
  42. Ghert M. A., Davis A. M., Griffin A. M. et al. The surgical and functional outcome of limbsalvage surgery with vascular reconstruction for soft tissue sarcoma of the extremity. Ann SurgOncol 2005;12:1102.
  43. Gortzak Y., Lockwood G. A., Mahendra A. et al. Prediction of pathologic fracture risk of the femur after combined modality treatment of soft tissue sarcoma of the thigh. Cancer 2010;116:1553.
  44. Pak D., Vineberg K. A., Griffith K. A. et al. Doseeffect relationships for femoral fractures after multimodality limbsparing therapy of softtissue sarcomas of the proximal lower extremity. Int J RadiatOncolBiolPhys 2012;83:1257.
  45. Cannon C. P., Ballo M. T., Zagars G. K. et al. Complications of combined modality treatment of primary lower extremity softtissue sarcomas. Cancer 2006;107:2455.
  46. Holt G. E., Griffin A. M., Pintilie M. et al. Fractures following radiotherapy and limbsalvage surgery for lower extremity softtissue sarcomas. A comparison of highdose and lowdose radiotherapy. J Bone Joint Surg Am 2005;87:315.
  47. Dickie C. I., Parent A. L., Griffin A. M. et al. Bone fractures following external beam radiotherapy and limbpreservation surgery for lower extremity soft tissue sarcoma: relationship to irradiated bone length, volume, tumor location and dose. Int J RadiatOncolBiolPhys 2009;75:1119.
  48. Duffy G. P., Wood M. B., Rock M. G., Sim F. H. Vascularized free fibular transfer combined with autografting for the management of fracture nonunions associated with radiation therapy. J Bone Joint Surg Am 2000;82:544.
  49. Pisters P. W., Leung D. H., Woodruff J. et al. Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities. J ClinOncol 1996;14:1679.
  50. Williard W. C., Hajdu S. I., Casper E. S., Brennan M. F. Comparison of amputation with limbsparing operations for adult soft tissue sarcoma of the extremity. Ann Surg 1992;215:269.
  51. LeVay J., O’Sullivan B., Catton C. et al. Outcome and prognostic factors in soft tissue sarcoma in the adult. Int J RadiatOncolBiolPhys 1993;27:1091.
  52. Sadoski C., Suit H. D., Rosenberg A. et al. Preoperative radiation, surgical margins, and local control of extremity sarcomas of soft tissues. J SurgOncol 1993;52:223.
  53. Herbert S. H., Corn B. W., Solin L. J. et al. Limbpreserving treatment for soft tissue sarcomas of the extremities. The significance of surgical margins. Cancer 1993;72:1230.
  54. Trovik C. S., Bauer H. C., Alvegård T. A. et al. Surgical margins, local recurrence and metastasis in soft tissue sarcomas: 559 surgically treated patients from the Scandinavian Sarcoma Group Register. Eur J Cancer 2000;36:710.
  55. Zagars G. K., Ballo M. T., Pisters P. W. et al. Prognostic factors for patients with localized softtissue sarcoma treated with conservation surgery and radiation therapy: an analysis of 1225 patients. Cancer 2003;97:2530.
  56. Gronchi A., Lo Vullo S., Colombo C. et al. Extremity soft tissue sarcoma in a series of patients treated at a single institution: local control directly impacts survival. Ann Surg 2010;251:506.
  57. Verhey L. J. Comparison of threedimensional conformal radiation therapy and intensitymodulated radiation therapy systems. SeminRadiatOncol 1999;9:78.
  58. Pan E., Goldberg S. I., Chen Y. L. et al. Role of postoperative radiation boost for soft tissue sarcomas with positive margins following preoperative radiation and surgery. J SurgOncol 2014;110:817.
  59. Kepka L., Suit H. D., Goldberg S. I. et al. Results of radiation therapy performed after unplanned surgery (without reexcision) for soft tissue sarcomas. J SurgOncol 2005;92:39.
  60. Eilber F. R., Eckardt J. Surgical management of soft tissue sarcomas. SeminOncol 1997;24:526.
  61. Potter B. K., Hwang P. F., Forsberg J. A. et al. Impact of margin status and local recurrence on soft-tissue sarcoma outcomes. J Bone Joint Surg Am 2013;95 (20):1511–8.
  62. Kasper B., Ouali M., van Glabbeke M. et al. Prognostic factors in adolescents and young adults (AYA) with high risk soft tissue sarcoma (STS) treated by adjuvant chemotherapy: a study based on pooled European Organisation for Research and Treatment of Cancer (EORTC) clinical trials 62771 and 62931. Eur J Cancer 2013;49 (2):449–56.
  63. Daigeler A., Harati K., Goertz O. et al. Prognostic factors and surgical tactics in patients with locally recurrent soft tissue sarcomas. HandchirMikrochirPlastChir 2015;47 (2):118–27.
  64. Daigeler A., Zmarsly I., Hirsch T. et al. Long-term outcome after local recurrence of soft tissue sarcoma: a retrospective analysis of factors predictive of survival in 135 patients with locally recurrent soft tissue sarcoma. Brit J Cancer 2014;110 (6):1456–64.
  65. Deroose J. P., Grunhagen D. J., de Wilt J. H. et al. Treatment modifications in tumour necrosis factor-alpha (TNF) – based isolated limb perfusion in patients with advanced extremity soft tissue sarcomas. Eur J Cancer 2015;51 (3):367–73.
  66. Wang T., Lin J., Song D., Zheng H., Hou C., Li L., Wu Z. Anatomical basis and design of the distally based lateral dorsal cutaneous neuro-lateral plantar venofasciocutaneous flap pedicled with the lateral plantar artery perforator of the fifth metatarsal bone: a cadaveric dissection. SurgRadiolAnat 2016;10 (7):1712–016.
  67. Li L., Song D., Zheng H., Hou C., Lin J., Xie Z., Zhuang Y. Anatomical basis of the reverse lateral plantar artery perforator flap design. SurgRadiolAnat 2015; 37:983–988.
  68. Song D., Yang X., Wu Z., Li L., Wang T., Zheng H., Hou C. Anatomic basis and clinical application of the distally based medialispedis flaps. SurgRadiolAnat 2016;38:213–221.
  69. Wu Z., Song D., Lin J., Zheng H., Hou C., Li L., Wang T. Anatomic basis of the distally based venocutaneous flap on the medial plantar artery of the hallux with medial plantar vein and nutrient vessels: a cadaveric dissection. SurgRadiolAnat 2015;37:975–981.
  70. Noever G., Bruser P., Kohler L. Reconstruction of heel and sole defects by free flaps. PlastReconstrSurg 1986;78:345–352.
  71. Hidalgo D. A., Shaw W. W. Anatomic basis of plantar flap design. PlastReconstrSurg 1986;78 (5):627–36.
  72. Hidalgo D. A., Shaw W. W. Reconstruction of foot injuries. ClinPlastSurg 1986;13 (4):663–80.
  73. Chang S. M., Li X. H., Gu Y. D. Distally based perforator sural flaps for foot and ankle reconstruction. World J Orthop 2015;6 (3):322–30.
  74. Jordan D. J., Malahias M., Hindocha S., Juma A. Flap decisions and options in soft tissue coverage of the lower limb. Open Orthop J 2014;8:423–32.
  75. Mileto D., Cotrufo S., Cuccia G., Delia G., Risitano G., Colonna M. R. et al. The distally based sural flap for lower leg reconstruction: versatility in patients with associated morbidity. Ann ItalChir 2007;78 (4):323–7.
  76. Akhtar S., Hameed A. Versatility of the suralfasciocutaneous flap in the coverage of lower third leg and hind foot defects. J PlastReconstrAesthetSurg (2006) 59 (8):839–45.10.1016/j.bjps.2005.12.009
  77. Kneser U., Bach A. D., Polykandriotis E., Kopp J., Horch R. E. Delayed reverse sural flap for staged reconstruction of the foot and lower leg. PlastReconstrSurg 2005;116 (7):1910–7.
  78. Ali F., Harunarashid H., Yugasmavanan K. Delayed reverse sural flap for cover of heel defect in a patient with associated vascular injury. A case report. Indian J Surg 2013;75 (Suppl 1):148–9.
  79. Ali M. A., Chowdhury P., Ali M., IftekerIbne Z., Dev J. Distally-basedsural island flap for soft tissue coverage of ankle and heel defects. J Coll Physicians Surg Pak 2010;20 (7):475–7.
  80. Mendieta M. J., Roblero C., Vega J. C. Neurotized distally based sural flap for heel reconstruction. J ReconstrMicrosurg 2013;29 (8):501–4.
  81. Tan O., Aydin O. E., Demir R., Barin E. Z., Cinal H., Algan S. Neurotizedsural flap: an alternative in sensory reconstruction of the foot and ankle defects. Microsurgery 2015;35 (3):183–9.
  82. Bibbo C. Plantar heel reconstruction with a sensate plantar medial artery musculocutaneouspedicled island flap after wide excision of melanoma. J Foot Ankle Surg 2012;51 (4):504–8.
  83. Kwan M. K., Merican A. M., Ahmad T. S. Reconstruction of the heel defect with in-step island flap. A report of four cases. Med J Malaysia 2005;60 (Suppl C):104–7.
  84. Dong K. X., Xu Y. Q., Fan X. Y., Xu L. J., Su X. X., Long H. et al. Perforator pedicled propeller flaps for soft tissue coverage of lower leg and foot defects. OrthopSurg 2014;6 (1):42–6.
  85. Fischer S., Klinkenberg M., Behr B., Hirsch T., Kremer T., Hernekamp F. et al. Comparison of donor-site morbidity and satisfaction between anterolateral thigh and parascapular free flaps in the same patient. J ReconstrMicrosurg 2013;29 (8):537–44.
  86. Klinkenberg M., Fischer S., Kremer T., Hernekamp F., Lehnhardt M., Daigeler A. Comparison of anterolateral thigh, lateral arm, and parascapular free flaps with regard to donor-site morbidity and aesthetic and functional outcomes. PlastReconstrSurg 2013;131 (2):293–302.
  87. Sauerbier M., Dittler S., Kreutzer C. Microsurgical chest wall reconstruction after oncologic resections. SeminPlastSurg 2011;25 (1):60–9.
  88. Saba S. C., Shaterian A., Tokin C., Dobke M. K., Wallace A. M. The pedicledmyocutaneous flap as a choice reconstructive technique for immediate adjuvant brachytherapy in sarcoma treatment. CurrOncol 2012;19 (6):e491–5.
  89. Hughes T. M., Thomas J. M. Sarcoma metastases due to iatrogenic implantation. Eur J SurgOncol 2000;26 (1):50–2.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2017 Tsilenko K.S., Kubirov M.S., Konovalov D.M.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: ПИ № ФС 77 - 81892 от 24.09.2021 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies