Surgical Treatment Methods And Prognosis Analysis Of Soft Tissue Sarcoma With "Involving" Vascular Nerves

Objective:To evaluate the surgical treatment of soft tissue sarcoma(STS)with vascular involvement and to propose the classification of vascular involvement.Methods:This study made a retrospective analysis of the clinical data of patients with limb salvage surgery and soft-tissue sarcoma of the first affiliated hospital of Xinjiang Medical University from December 2016 to December 2021.All patients underwent preoperative MRI examination and local enhanced CT for patients with complex anatomical structure,according to the relationship between tumor and vascular nerve was divided into three categories:(1)Tumor and vascular nerve contact surface 1circumference 180(type A),the corresponding blood vessels for artificial vascular replacement or vascular transplantation,and the corresponding nerve resection.(2)The Angle of the contact surface of the tumor and the vascular nerve is <180(type B),and the corresponding vascular nerve membrane is completely dissected and the trunk is retained.(3)The vascular nerve is far away from the tumor(type C),and the tumor is completely removed by surgery,and the vascular nerve membrane is preserved.Results:All 48 patients had R0 resection,and 7 patients with type A(14.6%)underwent artificial vascular replacement or neuroangiectomy.9 type B(18.8%)underwent vascular epineurium dissection.C(66.6%),complete tumor resection was performed.Type B local recurrence 22.2%,distant metastasis 11.1%,type C 21.9%,and distant metastasis 9.4%,and adventitial dissection of type B vascular nerves had no effect on the recurrence and overall survival of the disease.Conclusion:In patients with tumor "involving" vascular nerve,if the dissection of the outer membrane of type B vascular nerve has no significant effect on disease recurrence or survival,this surgical procedure is feasible.Thus,the precise classification of "involved" vascular nerves may help to select the appropriate degree of resection without compromising tumor outcome or unnecessarily sacrificing function.