Guidelines for Complications of Cancer Treatment Vol VIII Part B

an excellent alternative to amputation with very good localcontrol and limb preservation rates. Often a major nerve issacrificed but the function in the lower limb is still good.Leggon et al reported their experience with 14 patients of limbsarcoma with vessel reconstruction 3 . They also analysed theliterature till 1996 and reported that amputation was notnecessary as vessels could be reconstructed and limbssuccessfully salvaged (88%) despite a high rate of localcomplications. In half their cases a major nerve was alsoresected with the vessels. They reported a 26% infection ratefor prosthetic grafts compared to 3% with the autogenous veingraft. The pooled cases from literature also showed similarfindings.The german group 5 reported their experience with 21 cases ofvessel resection in lower extremity STS with vesselreconstruction. Vein was reconstructed only if greatersaphenous vein (GSV) was not patent or previously removed.43% incidence of vessel infiltration was reported. Local controlrate was 86% and the limb survival rate was 94%. Goodfunction was retained and patients were happy that anamputation was avoided. They conclude that vessel infiltrationis a possible negative prognostic factor in extremity STS andthe use of the autologous vein has not proven to be superior tosynthetic grafts with respect to the long-term patency rate afterlimb-salvage surgery.Tsukushi et al 6 analysed 25 cases of vascular reconstruction,13 with both artery and vein and 12 with only the arteryreconstructed after resection of soft tissue sarcomas involvingthe vessels as judged on MRI. They found no difference inoutcomes of the two groups implying no advantage of theadditional vein reconstruction. Though the patency rates ofthe vein were much lower, there did not appear any differencebetween autogenous vein graft and the PTFE graft. No localrecurrence was observed, which is remarkable considering that147