Indications and clinical outcomes in patients with soft-tissue sarcoma attached to the bone receiving tumorendoprosthetic replacement after tumor resection.

Introduction: Bone resection followed by endoprosthetic reconstruction (EPR) in the treatment of soft tissue sarcoma (STS) is rare and associated with unique challenges. This study aimed to analyze the indications, results and factors affecting the results of these cases.

Materials And Methods: Twelve patients (7 men and 5 women, median age 49 years) who underwent resection and endoprosthetic reconstruction due to soft tissue sarcoma of the extremity between 2010 and 2021 were analyzed retrospectively. The most common localization was the thigh (66%), and the most common diagnosis myxofibrosarcoma (33%). The most frequent Indications for the endoprosthetic reconstruction after soft tissue tumor resections were the close relationship of the tumor to the bone (n = 6), and suspicious bone infiltration on magnetic resonance imaging (MRI) (n = 5).

Results: Eight patients (66%) had no evidence of disease at the last follow-up examination (median 62 months), while 4 patients died after an average of 14 months. In 4 of 5 cases in which suspicious bone infiltration was detected on magnetic resonance imaging, the bone lesion was confirmed histopathologically. A Whoops procedure history was significantly negative prognostic in terms of limb survival (p < 0.045).

Conclusions: In bone-infiltrating or highly bone surrounding soft tissue sarcomas, wide resection including resection of the affected bone followed by endoprosthetic reconstruction seem to be a recommendable limb-salvage option with good oncological results and acceptable complication rate. The presence of bone infiltration at time of surgery does not increase the risk of local recurrence. A Whoops procedure history significantly reduce the limb survival.