Oncovascolar surgery: multidisciplinary approach in the removal of the musculoskeletal tumor and associated revascularization. Results and complications.

Introduction: The radical strategy of the tumor’s removal associated with limb salvage has become a primary objective. The purpose of this study is to describe the characteristics and results of surgical options for patients with musculoskeletal cancer and indication for radical resection, in our recent experience in collaboration with the oncology center of Rome and the IFO Division of Orthopedics University of Rome Tor Vergata. Methods: Between 2007 and 2011, were treated 30 patients affected by primitive and secondary musculoskeletal neoplasm with a mean age of 44 years (14-67 years) in 26 cases (86.6%) were required revascularization. Women accounted for 53.84% (14/26), 46.16% were men (12/26). The study included a preoperative biopsy of the lesion and ultrasonography and angio-CT with multiplanar reconstructions for the evaluation of the vascular anatomy. Results: The average postoperative follow-up was 19.4 months. The reconstruction of the vessels has been implemented in 12/26 (46%) mainly using the autologous saphenous contralateral vein. The use of the prosthesis was performed in the others cases (with PTFE and Dacron K prosthesis). In 4 cases the patients had lower limb edema, with a distance venous patency of 80% and arterial patency of 100%. We had no mortality at 30 days. Two patients underwent VAC therapy. No amputations were performed at 30 days. In 14 patients was performed perioperative chemotherapy or radiotherapy. The data were analyzed using SPSS 18.0 for Windows. Conclusions: A long-term evaluation is needed to determine the implications at a distance in patients undergoing radical resection of cancer in which are necessary for skills