Introduction: For patients affected by extremity or trunk soft-tissue sarcomas (STS) large resections might be needed to achieve negative margins.This is a common scenario especially in locally advanced or recurrent tumors often within a pre-irradiated field.The objective of this study was to evaluate the results of free-flap reconstructions (FFR) after sarcoma surgery.Objective: The endpoints were surgical results, quality of surgical margins and oncological outcome.
Methods: Retrospective analysis of patients with extremity and trunk STS with free-flap reconstruction between 2008 and 2022.Demographic and tumor data, perioperative treatment, margin status, morbidity and evolution mega motion lc100 were evaluated.Results: Of 467 patients, 25 (5.35%) required 26 free-flap reconstructions.
Surgery was performed on an irradiated field in 8 (32%) patients.Reconstructions were mostly needed for distal lower extremity resections and the most common type of flap used was antero-lateral tight (ALT) flap.No R2 resections were performed.R0 and R1 resections were achieved in 22 (84.
6%) and 4 (15.4%), respectively.All R1 resections were preplanned positive along a preserved critical structure.Surgical morbidity rate was 26% (7/26) and the re-operation rate was 15% (4/26) with 7.
7% flap losses (2/26).At a median follow-up of 38 months, 7 (28%) patients presented local recurrences.Conclusion: In a referral sarcoma royal fryer rft-50 center, having a multidisciplinary surgical team capable of complex resections and reconstructions is of utmost importance for a correct and integral surgical planning.This allows optimal oncologic resections with acceptable morbidity.