Chirurgie des sarcomes des tissus mous des membres chez l'adulte : historique et avancées thérapeutiques

Translated title of the contribution: Function preserving surgery of limb sarcomas: history and improvements

S. Bonvalot, M. C. Missana, A. Le Cesne, G. Missenard, D. Vanel, P. Terrier, C. Le Péchoux

Research output: Contribution to journalArticle

Abstract

In the seventies, limb-sparing surgery and radiation therapy appeared capable of successfully treating the great majority of adult patients with soft tissue sarcomas of the extremities. No survival benefit could be demonstrated in the patients selected for amputation. Microscopically positive surgical margins are related to a greater risk of local recurrence, whereas overall survival is compromised by high grade and large tumor size. Presurgery multidisciplinary discussion, management in reference center and management within cancer network independently predict conformity to the clinical practice guidelines. Reoperation should be a planned part of definitive management whenever the initial surgical procedure was done without a histologic diagnosis or was not planned to be a wide excision. Soft tissue flap reconstruction facilitates therapy for patients with locally advanced tumors so that patients with larger tumors can undergo resection, limiting complications and limb sacrifice. Vascular reconstruction is a feasible option in case of involvement of major vessels. Isolated limb perfusion (ILP) with TNF and chemotherapy is an efficient limb-sparing neoadjuvant therapy for locally advanced limb soft tissue sarcomas. Efficacy and safety of low-dose TNFα could greatly facilitate ILP procedures in the near future.

Original languageFrench
Pages (from-to)416-424
Number of pages9
JournalCancer/Radiotherapie
Volume10
Issue number6-7
DOIs
Publication statusPublished - Nov 2006

Fingerprint

Sarcoma
Extremities
History
Neoplasms
Perfusion
Neoadjuvant Therapy
Survival
Reoperation
Amputation
Practice Guidelines
Blood Vessels
Radiotherapy
Safety
Recurrence
Drug Therapy

Keywords

  • Isolated limb perfusion
  • Sarcoma
  • Surgery
  • TNF

ASJC Scopus subject areas

  • Oncology

Cite this

Bonvalot, S., Missana, M. C., Le Cesne, A., Missenard, G., Vanel, D., Terrier, P., & Le Péchoux, C. (2006). Chirurgie des sarcomes des tissus mous des membres chez l'adulte : historique et avancées thérapeutiques. Cancer/Radiotherapie, 10(6-7), 416-424. https://doi.org/10.1016/j.canrad.2006.05.015

Chirurgie des sarcomes des tissus mous des membres chez l'adulte  : historique et avancées thérapeutiques. / Bonvalot, S.; Missana, M. C.; Le Cesne, A.; Missenard, G.; Vanel, D.; Terrier, P.; Le Péchoux, C.

In: Cancer/Radiotherapie, Vol. 10, No. 6-7, 11.2006, p. 416-424.

Research output: Contribution to journalArticle

Bonvalot, S, Missana, MC, Le Cesne, A, Missenard, G, Vanel, D, Terrier, P & Le Péchoux, C 2006, 'Chirurgie des sarcomes des tissus mous des membres chez l'adulte : historique et avancées thérapeutiques', Cancer/Radiotherapie, vol. 10, no. 6-7, pp. 416-424. https://doi.org/10.1016/j.canrad.2006.05.015
Bonvalot, S. ; Missana, M. C. ; Le Cesne, A. ; Missenard, G. ; Vanel, D. ; Terrier, P. ; Le Péchoux, C. / Chirurgie des sarcomes des tissus mous des membres chez l'adulte  : historique et avancées thérapeutiques. In: Cancer/Radiotherapie. 2006 ; Vol. 10, No. 6-7. pp. 416-424.
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