Leiomyosarcomas affecting main vessels in the lower extremities
| Autor: | J. Martinez Zaragoza, R. Rojas Sayol, A. Grau Blanes, L. Trullols Tarragó, A. Peiró Ibañez, J.M. Romero Carro, E. Britez Altamirano, I. Gracia Alegria |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Average diameter business.industry Tumor resection Complete remission En bloc resection Vascular bypass 030204 cardiovascular system & hematology Surgery Resection body regions 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Epidemiology medicine Orthopedics and Sports Medicine business Survival rate |
| Zdroj: | Revista Española de Cirugía Ortopédica y Traumatología (English Edition). 62:401-407 |
| ISSN: | 1988-8856 |
| DOI: | 10.1016/j.recote.2018.05.003 |
| Popis: | Objective To evaluate the results of bloc resection and vascular reconstruction of leiomyosarcomas with involvement of main vessels in the lower extremities. Material and methods From January 1983 to December 2016, 42 patients with leiomyosarcomas were diagnosed. Six of these leiomyosarcomas affected main vessels of the lower extremities (called vascular). Epidemiological data, imaging studies, surgery performed, adjuvant treatments, complications, as well as recurrences and mortality were retrospectively recorded. Results All the patients were affected by high-grade leiomyosarcomas (II–III FNCLCC classification), with a larger tumour average diameter of 9.1 cm (6–15) and a mean follow-up of 23 months (7–36). The average age was 64 years (29–84). The first symptom was a palpable tumour in 4 of them. The other 2 cases debuted with thromboembolic phenomena. In 5 cases the origin was the femoral vessels, while one case was at the popliteal level. Although all cases preserved the limb, in 3 cases (50%) they presented pulmonary dissemination, 2 cases (33%) hepatic dissemination and one case had local recurrence. Two cases died at the end of the study and there was one case of loss to follow-up. Discussion and conclusions Vascular leiomyosarcomas are highly aggressive tumours with a low survival rate at 5 years. In our study, 50% of the patients remain in complete remission with a mean follow-up of 23 months. Their onset frequently associates the presence of tumour mass with thrombotic phenomena (33% of our cases). Tumour resection surgery usually compromises the main vascular structures, which implies resection and vascular reconstructive techniques to salvage the limb. |
| Databáze: | OpenAIRE |
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