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Sarcoma
Volume 2018 (2018), Article ID 6483579, 8 pages
https://doi.org/10.1155/2018/6483579
Research Article

Limb-Salvage Surgery of Soft Tissue Sarcoma with Sciatic Nerve Involvement

1Department of Surgery, Clinical Center Frankfurt Höchst, Frankfurt, Germany
2Department of Trauma and Orthopedic Surgery, BG Trauma Center, Frankfurt, Germany
3Institute for Pathology, Clinical Center Frankfurt Höchst, Frankfurt, Germany
4Radiological Institute, Agaplesion Markus Hospital, Frankfurt, Germany
5Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt, Germany
6Department of Vascular and Endovascular Surgery, Heidelberg University Hospital, Heidelberg, Germany

Correspondence should be addressed to Hussein Sweiti; moc.liamg@itiewsh

Received 11 November 2017; Accepted 8 February 2018; Published 6 March 2018

Academic Editor: Valerae O. Lewis

Copyright © 2018 Hussein Sweiti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The surgical resection of soft tissue sarcomas (STS) with sciatic nerve involvement presents a significant surgical and oncological challenge. Current treatment strategies pursue a multimodal approach with the aim of limb preservation. We aim to evaluate the outcomes of limb-sparing surgery of STS in a patient cohort and to propose a classification for STS with sciatic nerve involvement. Methods. Patients receiving limb-preserving resections for STS with sciatic nerve involvement between 01/2010 and 01/2017 were included. Clinical and oncological data were prospectively collected in a computerized database and retrospectively analyzed. Sciatic nerve involvement in STS was classified preoperatively as follows: type A for nerve encasement; type B for nerve contact; and type C for no nerve involvement. Results. A total of 364 patients with STS were treated, of which 27 patients had STS with sciatic nerve involvement. Eight patients with type A tumors (29.6%) underwent sciatic nerve resection, and 19 patients with type B tumors (70.4%) received epineural dissections. Disease progression was observed in 8 patients (29.6%) with a local recurrence of 11.1% and distant metastasis in 29.6%. The type of nerve resection significantly influenced leg function but had no impact on disease recurrence or overall survival. Conclusion. In a cohort of carefully selected patients with STS and sciatic nerve involvement, the extent of sciatic nerve resection had no significant impact on disease recurrence or survival. Precise classification of neural involvement may therefore be useful in selecting the appropriate degree of nerve resection, without compromising oncological outcome or unnecessarily sacrificing leg function.