Neurovascular invasion in bone sarcoma. Which limiting factor to limb salvage ? (about 520 patients)
G. Delépine
Hôpital R Poincaré -Oncologic Pediatric unit
Garches

EFORT 2008 Nice 29 au 31 mai 2008

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Material
From 1/1981 To 31 /12/2003
520 sarcomas of limb or girdle.
Average size 13.1 cms.
265 Osteosarcomas
135 chondrosarcomas
130 Ewing’ s sarcoma

Method
 All patients had Xrays and CT scan
 350 NMR
 45 vascular exploration
 Their results were compared to the operative constatations and to histologic findings

Results in osteosarcoma

The artery was not involved

Huge pelvic osteosarcoma
 Resection showed no NV invasion .10 years DFS

Others cases without NV invasion
.
In chondrosarcoma NV invasion is exceptional : 5%

 Sciatic nerve invahided

Neurovascular invasion was not observed in Ewing
 Even in very huge tumors

Conclusions
Neurovascular invasion is too rare to limit significantly limb salvage in bone sarcoma