(P 252) A NOVEL MULTIDISCIPLINARY SURGICAL APPROACH TO PERIPHERAL NERVE SHEATH TUMORS AND SOFT TISSUE SARCOMAS.

Objective: Peripheral Nerve Sheath tumors are rare in the population, with only 5% of them classified as malignant. Moreover, benign and malignant soft tissue tumors that envelop or compress peripheral nerves can significantly inflict pain and impact the quality of life of such patients, particularly when located in the extremities. In general these lesions are being operated by peripheral nerve surgeons or microsurgeons and not by orthopedic oncology surgeons. The aim of this study was to evaluate the results of a novel multidisciplinary surgical approach to soft tissue sarcoma and neurolysis of involved peripheral nerves.

Methods: A total of 189 patients who underwent a neurolysis of peripheral nerves entrapped by a soft tissue lesion were included. This procedure employed an innovative multidisciplinary approach, combining the expertise of an orthopedic oncology surgeon and a neurosurgeon team using microsurgery and neuromonitoring. All cases were performed by the same team to ensure consistency.

Results: Following an MRI evaluation, the study included 117 female patients and 72 male patients, with a mean age of 42 (ranging from 11 to 55 years) during the years 2014-2024. The team operated on a variety of pathologies, including 59 soft tissue sarcomas, 8 malignant peripheral nerve sheath tumor (MPNST), 41 neurofibromas, 27 schwannomas, 54 atypical lipomas. In all follow-up visits, majority of patients reported immediate pain relief. The mean follow-up period was 7 years (ranging from 2 to 10 years), infections were seen in 10 patients following radiation therapy, whoops procedure was seen in 4 cases. no recurrence of the tumors following resection was seen.

Conclusion: We introduce a groundbreaking surgical approach for the treatment of soft tissue tumors surrounding peripheral nerves, involving the collaboration of a neurosurgery-orthopedic oncology team. By combining the extensive surgical techniques of orthopedic oncology with microsurgery, we successfully achieved tumor- free neurolysis of the peripheral nerves.