Background:
Nowadays the active search of prophylaxis and treatment methods of local
recurrence of soft tissue sarcomas is being held. The frequency of
primary recurrences reaches 20-30% of all patients who underwent
surgery.
At the same time, the frequency of repeated relapse reaches 50%.
Herewith today there is stable tendency for the functionally-sparing and
organ-preserving intervention to be carried out.
Aim:
The improvement of treatment results in patients with soft tissue sarcoma recurrence.
Methods:
We used the combination of surgical treatment with preoperative x-ray endovascular vessels embolisation, feeding the tumor, and cryosurgical effect on deleted tumor bed.
Our basic research group was made up of 64 patients with repeated
recurrent soft tissue sarcoma of the limbs, to whom we carried out
preoperative selective x-ray endovascular embolisation of feeding
vessels with following intraoperative cryo- effect on deleted tumor bed.
On the first stage these patients got partial and full reduction of
blood flow in the tumor with the help of x-ray endovascular method.
The next stage included surgical deletion of recurrence with
preservation of the limb and its functions. Then we carried out
cryo-effect on deleted tumor bed.
The control group included 81 patients. This group was comparable with
the basic group according to clinical social indicator. These patients
underwent surgery from 1995 to 2005, long before we could apply
technical capabilities of using x-ray endovascular methods and
cryolysis.
Results and conclusions:
The observation period in the basic group was from 2 to 7 years. In the result of the work that had been carried out we managed to reduce intraoperative blood loss volume 1,4 times in the patients of the main group. Besides, the using of combined approach lets reduce the number of repeated local recurrence of soft tissue sarcomas 1,8 times during organ-preserving surgical interventions.