{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:43:46Z","timestamp":1789685026119,"version":"4.0.1"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The management of extremity soft tissue sarcomas (STS) involving major vessels presents unique challenges, historically leading to amputation. Advances in vascular reconstruction have enabled limb\u2010sparing surgery (LSS), but outcomes and perioperative risks remain uncertain. This systematic review and meta\u2010analysis aimed to evaluate oncologic results following LSS with vascular reconstruction in extremity STS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and single\u2010arm meta\u2010analysis 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\u2010effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010one 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%\u201392%), while amputation occurred in 10% (95% CI, 8%\u201314%). One\u2010 and 5\u2010year overall survival rates were 89% and 62%, respectively, with disease\u2010free survival rates of 74% and 55%. Major complications included graft thrombosis (19%), wound complications (29%), and wound infection (22%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Limb\u2010sparing surgery with vascular reconstruction is effective for extremity STS involving major vessels, enabling high limb salvage and favorable long\u2010term 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70194","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T07:36:06Z","timestamp":1767944166000},"page":"486-510","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Vascular Reconstruction in Extremity Soft Tissue Sarcomas: A Systematic Review and Single\u2010Arm Meta\u2010Analysis"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7687-3073","authenticated-orcid":false,"given":"Lucas Monteiro","family":"Delgado","sequence":"first","affiliation":[{"name":"Universidade Federal de Minas Gerais (UFMG), Belo Horizonte\u2010MG Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2960-3810","authenticated-orcid":false,"given":"Bernardo Fontel","family":"Pompeu","sequence":"additional","affiliation":[{"name":"Surgery Department Hospital Heli\u00f3polis S\u00e3o Paulo Brazil"},{"name":"University of S\u00e3o Caetano do Sul S\u00e3o Caetano do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5424-6983","authenticated-orcid":false,"given":"Vin\u00edcius dos Santos","family":"Macedo","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais (UFMG), Belo Horizonte\u2010MG Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5783-4083","authenticated-orcid":false,"given":"Gabriel Henrique Acedo","family":"Martins","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais (UFMG), Belo Horizonte\u2010MG Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6484-1162","authenticated-orcid":false,"given":"Eric","family":"Pasqualotto","sequence":"additional","affiliation":[{"name":"Universidade Federal de Santa Catarina (UFSC) Florian\u00f3polis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0652-7615","authenticated-orcid":false,"given":"Matheus Reginato","family":"Araujo","sequence":"additional","affiliation":[{"name":"Surgery Department Hospital Heli\u00f3polis S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9321-2330","authenticated-orcid":false,"given":"Julia Hoici","family":"Brunini","sequence":"additional","affiliation":[{"name":"Surgery Department Hospital Heli\u00f3polis S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9496-8746","authenticated-orcid":false,"given":"Victor Andrade","family":"Nunes","sequence":"additional","affiliation":[{"name":"University of North Carolina, Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1303-298X","authenticated-orcid":false,"given":"Cl\u00e1udia","family":"Theis","sequence":"additional","affiliation":[{"name":"University of North Carolina, Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3476-727X","authenticated-orcid":false,"given":"Samuel Aguiar","family":"Junior","sequence":"additional","affiliation":[{"name":"Sarcoma and Bone Tumors Reference Center \u2010 A.C. 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