Microvascular tissue transfer after the resection of soft tissue sarcomas

J Plast Reconstr Aesthet Surg. 2021 May;74(5):995-1003. doi: 10.1016/j.bjps.2020.11.013. Epub 2020 Nov 21.

Abstract

Background: Microvascular tissue transfer enables the oncological resection of soft tissue sarcomas of the extremities and the trunk by covering the resulting tissue defects that are often extensive. This study was performed to investigate the long-term survival and functional outcome of patients treated with free flaps after sarcoma resection.

Methods: A total of 78 sarcoma patients received microvascular tissue transfer in our institution between March 2003 and January 2013. In a retrospective analysis, we investigated data such as tumor characteristics as well as survival time and disease-free survival. In a prospective analysis, we assessed the functional outcome and the health-associated quality of life with the TESS and SF-36 questionnaire, respectively.

Results: Seventy patients qualified for disease-free survival after tumor resection, 41 patients remained disease free for over 5 years. Forty-five patients reached a survival time of more than 5 years. The functional results experienced by our patients were good with a mean score of 82.6% in the TESS. The physical health-related quality was lower than in the German norm sample and patients suffering from chronical illnesses or cancer, whereas the mental health was only slightly lower than in the norm sample and higher than in the groups with chronic illnesses or cancer (SF-36).

Conclusion: Microvascular tissue transfer enables tumor resection and limb salvage through the coverage of the resulting defects without impairing patients' prognosis. The long survival times after tumor resection emphasizes the need for good functional results as well as quality of life.

Keywords: Functional outcomes; Microvascular reconstruction; Quality of life; Soft tissue sarcoma; Survival time.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Extremities / surgery*
  • Female
  • Free Tissue Flaps*
  • Germany
  • Humans
  • Limb Salvage / methods*
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Plastic Surgery Procedures / methods*
  • Quality of Life
  • Retrospective Studies
  • Sarcoma / surgery*