Multiple Flap Transfer for Multiple Local Recurrence of Soft Tissue Sarcoma
<i>Background and Objectives</i>: Surgical management of local recurrence of soft tissue sarcomas (STS) is still challenging. In this article, we report on multiple flap reconstructions for multiple local recurrences of STS. Their feasibility will be validated by examining clinical cases...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/8/1489 |
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| author | Ryo Karakawa Hidehiko Yoshimatsu Yuma Fuse Tomoyuki Yano |
| author_facet | Ryo Karakawa Hidehiko Yoshimatsu Yuma Fuse Tomoyuki Yano |
| author_sort | Ryo Karakawa |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Surgical management of local recurrence of soft tissue sarcomas (STS) is still challenging. In this article, we report on multiple flap reconstructions for multiple local recurrences of STS. Their feasibility will be validated by examining clinical cases. <i>Materials and Methods</i>: Patients who underwent multiple flap reconstructions for multiple local recurrences of STS between April 1997 and October 2021 were included in this retrospective study. Patient demographics, tumor characteristics, surgical characteristics, and postoperative complications were examined. <i>Results</i>: Twenty operations of eight patients were identified. The location of the defects was the back in two, the buttock in two, the groin in two, and the lower extremities in two. The average total number of wide resections was 4.0 and the average total number of flap reconstructions was 2.5. The average follow-up period was 109.4 months. The average size of the defect was 102.4 cm<sup>2</sup> and the average flap size was 15.7 × 10.8 cm. The histological diagnoses were malignant fibrous histocytoma (MFH) in eight operations, osteosarcoma in two operations, myxoid liposarcoma in two operations, undifferentiated pleomorphic sarcoma (UPS) in six operations, and myxofibrosarcoma (MFS) in one operation. Of twelve subsequent operations, the resection of the previously transferred flap was performed in six operations (50%). The occurrence of take back, flap complications, and donor-site complications in the primary operation group was 25%, 25%, and 12.5%, respectively. The occurrence of take back, flap complications, and donor-site complications in the second and subsequent operation group was 0%, 0%, and 16.7%, respectively. <i>Conclusions</i>: Multiple operations including wide resections followed by flap reconstructions for multiple local recurrences are feasible. Reconstructive surgeons should choose the options of the flaps considering the future local recurrence for tumors with a high risk of recurrence. |
| first_indexed | 2024-03-10T23:45:18Z |
| format | Article |
| id | doaj.art-283320b8f4034a7aac18e20b211f8606 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T23:45:18Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-283320b8f4034a7aac18e20b211f86062023-11-19T02:07:08ZengMDPI AGMedicina1010-660X1648-91442023-08-01598148910.3390/medicina59081489Multiple Flap Transfer for Multiple Local Recurrence of Soft Tissue SarcomaRyo Karakawa0Hidehiko Yoshimatsu1Yuma Fuse2Tomoyuki Yano3Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, JapanDepartment of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, JapanDepartment of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, JapanDepartment of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan<i>Background and Objectives</i>: Surgical management of local recurrence of soft tissue sarcomas (STS) is still challenging. In this article, we report on multiple flap reconstructions for multiple local recurrences of STS. Their feasibility will be validated by examining clinical cases. <i>Materials and Methods</i>: Patients who underwent multiple flap reconstructions for multiple local recurrences of STS between April 1997 and October 2021 were included in this retrospective study. Patient demographics, tumor characteristics, surgical characteristics, and postoperative complications were examined. <i>Results</i>: Twenty operations of eight patients were identified. The location of the defects was the back in two, the buttock in two, the groin in two, and the lower extremities in two. The average total number of wide resections was 4.0 and the average total number of flap reconstructions was 2.5. The average follow-up period was 109.4 months. The average size of the defect was 102.4 cm<sup>2</sup> and the average flap size was 15.7 × 10.8 cm. The histological diagnoses were malignant fibrous histocytoma (MFH) in eight operations, osteosarcoma in two operations, myxoid liposarcoma in two operations, undifferentiated pleomorphic sarcoma (UPS) in six operations, and myxofibrosarcoma (MFS) in one operation. Of twelve subsequent operations, the resection of the previously transferred flap was performed in six operations (50%). The occurrence of take back, flap complications, and donor-site complications in the primary operation group was 25%, 25%, and 12.5%, respectively. The occurrence of take back, flap complications, and donor-site complications in the second and subsequent operation group was 0%, 0%, and 16.7%, respectively. <i>Conclusions</i>: Multiple operations including wide resections followed by flap reconstructions for multiple local recurrences are feasible. Reconstructive surgeons should choose the options of the flaps considering the future local recurrence for tumors with a high risk of recurrence.https://www.mdpi.com/1648-9144/59/8/1489sarcomaflaplocal recurrence |
| spellingShingle | Ryo Karakawa Hidehiko Yoshimatsu Yuma Fuse Tomoyuki Yano Multiple Flap Transfer for Multiple Local Recurrence of Soft Tissue Sarcoma Medicina sarcoma flap local recurrence |
| title | Multiple Flap Transfer for Multiple Local Recurrence of Soft Tissue Sarcoma |
| title_full | Multiple Flap Transfer for Multiple Local Recurrence of Soft Tissue Sarcoma |
| title_fullStr | Multiple Flap Transfer for Multiple Local Recurrence of Soft Tissue Sarcoma |
| title_full_unstemmed | Multiple Flap Transfer for Multiple Local Recurrence of Soft Tissue Sarcoma |
| title_short | Multiple Flap Transfer for Multiple Local Recurrence of Soft Tissue Sarcoma |
| title_sort | multiple flap transfer for multiple local recurrence of soft tissue sarcoma |
| topic | sarcoma flap local recurrence |
| url | https://www.mdpi.com/1648-9144/59/8/1489 |
| work_keys_str_mv | AT ryokarakawa multipleflaptransferformultiplelocalrecurrenceofsofttissuesarcoma AT hidehikoyoshimatsu multipleflaptransferformultiplelocalrecurrenceofsofttissuesarcoma AT yumafuse multipleflaptransferformultiplelocalrecurrenceofsofttissuesarcoma AT tomoyukiyano multipleflaptransferformultiplelocalrecurrenceofsofttissuesarcoma |