Revolutionizing bone tumor management: cutting-edge breakthroughs in limb-saving treatments.

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Abstract

[Indexed for MEDLINE] 11. Eur J Orthop Surg Traumatol. 2019 Feb;29(2):271-278. doi: 10.1007/s00590-019-02373-y. Epub 2019 Jan 8. Microsurgery in musculoskeletal oncology. Kontogeorgakos VA(1), Eward WC(2), Brigman BE(2). Author information: (1)Department of Orthopaedics, National and Kapodistrian University of Athens, Rimini 1, Xaidari, Athens, Greece. vaskonto@gmail.com. (2)Duke Cancer Institute, Duke University, Durham, NC, USA. Sarcomas are rare mesenchymal bone and soft tissue tumors of the musculoskeletal system. In the past, the primary treatment modality was amputation of the involved limb and the 5-year survival was very low for high-grade tumors. During the last three decades, limb salvage has become the rule rather than the exception and the use of neoadjuvant and adjuvant therapies (radiation and chemotherapy) has dramatically increased disease-free survival. Reconstruction of large bone and soft tissue defects, though, still remains a significant challenge in sarcoma patients. In particular, vascularized tissue transfer has proved extremely helpful in dealing with complex bone and soft tissue or functional defects that are frequently encountered as a result of the tumor or as a complication of surgery and adjuvant therapies. The principles, indications and results of microsurgical reconstruction differ from trauma patients and are directly related not only to the underlying disease process, but also to the local and systemic therapeutic modalities applied to the individual patient. Although plastic reconstruction in the oncological patients is not free of complications, usually these complications are manageable and do not jeopardize oncological outcome. The overall treatment strategy should be tailored to the patient's and sarcoma profile. DOI: 10.1007/s00590-019-02373-y