Surgical and computed tomography evaluation of soft tissur sarcomas

ABSTRACT

The current trend towards limb-sparing surgery in patients with soft tissue sarcomas increased the need for accurate preoperative assessment of the primary tumor. Tumor site, extent and relationship to the adjacent bone and neurovascular structures were evaluated to determine whether adequate radical surgery is feasible or more limited excision as a part of multimodality treatment is appropriate. Preoperative computed tomography [CT] was compared with operative findings in 18 patients with soft tissue sarcomas. CT prediction of muscle group involvement by the tumor was correct in 88.9% and that of major artery or vein invasion was correct in 83.3% and 94%, respectively. Assessment of the tumor relationship to major peripheral nerve was accurate for thigh sarcomas but was not possible in upper limb tumors. Although CT confirmed frank bony involvement in two patients, it failed to distinguish between tumors closely adjacent to periosteal and those with periosteal invasion. Detection of residual or recurrent tumor nodules by CT is less reliable. CT is the most useful and accurate method before surgical intervention