Primary tumors of the sartorial canal: limb sparing resection of soft-tissue sarcomas arising in a unique location

Abstract

Background 

Extracompartmental soft-tissue sarcomas of the sartorial canal grow in a virtual space in close proximity to the superficial femoral artery and vein and thus require a complex resection. This study was designed to assess the presentation pattern, preoperative evaluation and oncologic and functional outcomes.

Methods 

We retrospectively analyzed 15 patients with primary sartorial canal sarcomas. Ten patients had low-grade and five had high-grade tumors. Median follow-up was 47 (range, 20–240) months.

Results 

Limb-sparing surgery was achievable in all 15 patients. Only intra-operative evaluation accurately identified the three high-grade tumors that involved the vessels and necessitated vascular resection and reconstruction. Disease-free survival was 60% for high-grade (three of five) and 100% for low-grade sarcomas. There were no local recurrences. Functional outcome was excellent. Superficial delayed wound healing occurred in four patients.

Conclusions 

Most sartorial canal tumors are malignant. Their proximity to the superficial artery and vein poses a threat of early vascular wall involvement only in high-grade lesions. These often necessitate vascular resection and have poor survival outcomes. Limb-sparing surgery can be achieved by respecting intact biological barriers such as the vessel sheath. Soft-tissue reconstruction protects the vessels from complications after surgery or radiation. Return to full function can be expected.