Evidence map›Paper›PMID 41508787›Full record

SynthesisJournal of surgical oncology2026

Vascular Reconstruction in Extremity Soft Tissue Sarcomas: A Systematic Review and Single-Arm Meta-Analysis.

Lucas Monteiro Delgado, Bernardo Fontel Pompeu, Vinícius Dos Santos Macedo, Gabriel Henrique Acedo Martins, Eric Pasqualotto, Matheus Reginato Araujo, Julia Hoici Brunini, Victor Andrade Nunes, Cláudia Theis, Samuel Aguiar Junior

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lucas Monteiro DelgadoUniversidade Federal de Minas Gerais (UFMG), Belo Horizonte-MG, Belo Horizonte, Brazil.ORCID https://orcid.org/0009-0001-7687-3073
Bernardo Fontel PompeuSurgery Department, Hospital Heliópolis, São Paulo, Brazil.ORCID https://orcid.org/0009-0009-2960-3810
Vinícius Dos Santos MacedoUniversidade Federal de Minas Gerais (UFMG), Belo Horizonte-MG, Belo Horizonte, Brazil.ORCID https://orcid.org/0009-0005-5424-6983
Gabriel Henrique Acedo MartinsUniversidade Federal de Minas Gerais (UFMG), Belo Horizonte-MG, Belo Horizonte, Brazil.ORCID https://orcid.org/0009-0006-5783-4083
Eric PasqualottoUniversidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil.ORCID https://orcid.org/0000-0002-6484-1162
Matheus Reginato AraujoSurgery Department, Hospital Heliópolis, São Paulo, Brazil.ORCID https://orcid.org/0009-0002-0652-7615
Julia Hoici BruniniSurgery Department, Hospital Heliópolis, São Paulo, Brazil.ORCID https://orcid.org/0009-0001-9321-2330
Victor Andrade NunesUniversity of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0002-9496-8746
Cláudia TheisUniversity of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0002-1303-298X
Samuel Aguiar JuniorSarcoma and Bone Tumors Reference Center - A.C. Camargo Cancer Center, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-3476-727X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe management of extremity soft tissue sarcomas (STS) involving major vessels presents unique challenges, historically leading to amputation. Advances in vascular reconstruction have enabled limb-sparing surgery (LSS), but outcomes and perioperative risks remain uncertain. This systematic review and meta-analysis aimed to evaluate oncologic results following LSS with vascular reconstruction in extremity STS.

methodsA systematic review and single-arm meta-analysis were performed according to PRISMA guidelines, with registration in PROSPERO. PubMed, Embase, and Cochrane Library were searched from inception to June 2025 for studies reporting outcomes in patients with extremity STS undergoing LSS with vascular reconstruction. Pooled analyses estimated limb salvage, survival, and complication rates using random-effects models.

resultsThirty-one studies comprising 520 patients were included. Approximately 58% were male, with a mean age ranging from 29.3 to 59 years. The most common tumor localizations were the thigh (59.5%), inguinal region (15.9%), and popliteal fossa (8.6%). Liposarcoma (24.0%), synovial sarcoma (19.6%), and osteosarcoma (14.8%) were the most frequent histological subtypes. The pooled limb salvage rate was 89% (95% CI, 86%-92%), while amputation occurred in 10% (95% CI, 8%-14%). One- and 5-year overall survival rates were 89% and 62%, respectively, with disease-free survival rates of 74% and 55%. Major complications included graft thrombosis (19%), wound complications (29%), and wound infection (22%).

conclusionsLimb-sparing surgery with vascular reconstruction is effective for extremity STS involving major vessels, enabling high limb salvage and favorable long-term survival without compromising oncologic outcomes. However, substantial perioperative morbidity persists, underscoring the need for multidisciplinary care, careful patient selection, and prospective studies to refine indications and enhance quality of life.

Indexed as

ExtremitiesPlastic Surgery ProceduresSarcomaSoft Tissue NeoplasmsVascular Surgical ProceduresHumansLimb Salvagelimb salvagelimb‐sparing surgerymeta‐analysissoft tissue sarcomavascular reconstruction

Identifiers

PMID41508787
PMCPMC12989194

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.