This protocol covers malignant peripheral nerve sheath tumor arising in an extremity in which resection cannot be performed without significant morbidity or amputation — the subset of MPNST cases where standard limb-preserving surgery is not a feasible option.
While current guidelines recommend limb-preserving surgery as the primary surgical goal, a proportion of extremity MPNST cases present with tumour characteristics that make a conservative surgical approach unachievable. In this setting, clinical decision-making focuses on the appropriate operative strategy given that limb preservation carries unacceptable morbidity.
When limb-preserving resection is not achievable, the protocol defines a definitive operative intervention directed at the affected extremity — the specific indications, criteria, and procedural details are contained in the full regimen.