Key result
Limb-salvage surgery with vascular reconstruction for lower extremity sarcoma achieved a pooled overall limb-salvage rate of 89.8% (95% CI, 85.0-93.1%).
Why the study?
The low incidence of sarcoma and rarity of limb-salvage surgery have limited reliable study of limb-salvage surgery with vascular reconstruction for lower extremity sarcoma involving major vessels.
Does limb-salvage surgery with vascular reconstruction result in high limb-salvage rates in patients with lower extremity sarcoma?
Meta-Analysis (n=271)
Does limb-salvage surgery with vascular reconstruction result in high limb-salvage rates in patients with lower extremity sarcoma?
Limb-salvage surgery with vascular reconstruction for lower extremity sarcoma achieves a high limb-salvage rate of 89.8%, though perioperative complications remain high at 49.5%.
This is the authors' abstract. We don't add key points for this paper.
BACKGROUND: Limb-salvage surgery with vascular reconstruction is the current standard treatment when sarcoma involves major vessels of the lower extremity. However, the low incidence of sarcoma and rarity of limb-salvage surgery are limiting factors for the reliable study of limb-salvage surgery. Therefore, a systematic review was conducted to establish better management of lower extremity sarcoma based on currently available evidence. METHODS: A systematic review and meta-analysis of data on limb-salvage surgery with vascular reconstruction for lower extremity sarcoma were conducted using MEDLINE through PubMed, Scopus, CINARL, and Cochrane Database of Systematic Reviews. Overall limb-salvage rate was the primary outcome, and rates of perioperative complication and arterial patency were secondary outcomes. RESULTS: Among the 271 patients (18 studies) included in this study, 69.4% underwent arterial reconstruction with autologous graft, 22.0% underwent synthetic graft, and 8.6% underwent other reconstructive methods. Pooled overall limb-salvage rate was 89.8% [95% confidence interval (CI), 85.0-93.1%] after a mean follow-up of 19-74.7 months. Pooled overall perioperative complication and arterial patency rates were 49.5% (95% CI, 42.8-56.2%) and 85.4% (95% CI, 79.5-89.9%), respectively. CONCLUSIONS: Current evidence suggests that limb-salvage surgery with vascular reconstruction has a high limb-salvage rate; however, the high perioperative complication rate remains problematic. Early and appropriate interventions are required to optimize the complications of limb-salvage surgery.
Answers are grounded in this paper and cite their sources.
Supports limb-salvage surgery with vascular reconstruction in lower extremity sarcoma; confirms high pooled salvage rates across studies.
No takes yet. Share an insight, caveat, or question.
Fujiki et al. (2020) conducted a meta-analysis in Lower extremity sarcoma (n=271). Limb-salvage surgery with vascular reconstruction was evaluated on Overall limb-salvage rate (95% CI 85.0-93.1). Limb-salvage surgery with vascular reconstruction for lower extremity sarcoma achieved a pooled overall limb-salvage rate of 89.8% (95% CI, 85.0-93.1%).
Synapse has enriched 10 related papers. Consider them for comparative context: