Soft tissue sarcomas (STSs) gather over 80 histological entities, with even more molecular subsets, characterised by a low to very low incidence in all populations. The majority of sarcomas arise from the soft tissue (close to 75%), with 15% gastrointestinal stromal tumours (GISTs) and 10% bone sarcomas. These ESMO-EURACAN (European Society for Medical Oncology-European Reference Network for rare adult solid cancers) Clinical Practice Guidelines cover STSs, while GISTs are covered by dedicated ESMO-EURACAN Clinical Practice Guidelines [1]. Kaposi's sarcoma is not considered in the present document. Extraskeletal Ewing and Ewing-like sarcoma is covered by ESMO Clinical Practice Guidelines on bone sarcomas [2]. In general, the

Biomaterial-associated infections occur on both permanent implants and temporary devices for restoration or support of human functions. Despite increasing use of biomaterials in an aging society, comparatively few biomaterials have been designed that effectively reduce the incidence of biomaterial-associated infections. This review provides design guidelines for infection-reducing strategies based on the concept that the fate of biomaterial implants or devices is a competition between host tissue cell integration and bacterial colonization at their surfaces.

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Bacterial-infections are mostly due to bacteria in their biofilm-mode of growth. Nanotechnology-based antimicrobials possess excellent potential in biofilm-infection control, overcoming the biological barriers of biofilms.

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Pedicle screw fixation is technically demanding and associated with high complication rates. The aim of this study was to identify and quantify the pedicle screw-related complications in 105 consecutive operations. We retrospectively analysed 105 consecutive primary operations. We found complications of varying severity in 54% of the patients. Deep infections were found in 4.7%, all successfully cured by debridement and antibiotics. There were no permanent neurological complications related to the screws. One serious neurological sequela, a T10 paraplegia, was unrelated to screw placement between L3 and S1. Screw misplacement was found in 6.5% of the screws. Screw breakage occurred in 12.4% of the patients, inevitably leading to loss of correction. Reduced spondylolisthesis L5-S1 without anterior support was found to be especially prone to screw breakage. The study confirmed that pedicle screw placement is a technically demanding procedure with a high complication rate. Fortunately, most complications are not severe. Infections can be dealt with by thorough debridement and parenteral antibiotics. Neurological sequelae can be minimised by careful tactile technique. To avoid screw breakage and subsequent loss of correction, anterior support should be provided, through either posterior or anterior lumbar interbody fusion (PLIF or ALIF) techniques, in reduced spondylolisthesis L5-S1.

Background: Mesenchymal chondrosarcoma (MCS) is a distinct, very rare sarcoma with little evidence supporting treatment recommendations. Patients and methods: Specialist centres collaborated to report prognostic factors and outcome for 113 patients. Results: Median age was 30 years (range: 11-80), male/female ratio 1.1. Primary sites were extremities (40%), trunk (47%) and head and neck (13%), 41 arising primarily in soft tissue. Seventeen patients had metastases at diagnosis. Mean follow-up was 14.9 years (range: 1-34), median overall survival (OS) 17 years (95% confidence interval (CI): 10.3-28.6). Ninety-five of 96 patients with localised disease underwent surgery, 54 additionally received combination chemotherapy. Sixty-five of 95 patients are alive and 45 progression-free (5 local recurrence, 34 distant metastases, 11 combined). Median progression-free survival (PFS) and OS were 7 (95% CI: 3.03-10.96) and 20 (95% CI: 12.63-27.36) years respectively. Chemotherapy administration in patients with localised disease was associated with reduced risk of recurrence (P = 0.046; hazard ratio (HR) = 0.482 95% CI: 0.213-0.996) and death (P = 0.004; HR = 0.445 95% CI: 0.256-0.774). Clear resection margins predicted less frequent local recurrence (2% versus 27%; P = 0.002). Primary site and origin did not influence survival. The absence of metastases at diagnosis was associated with a significantly better outcome (P < 0.0001). Data on radiotherapy indications, dose and fractionation were insufficiently complete, to allow comment of its impact on outcomes. Median OS for patients with metastases at presentation was 3 years (95% CI: 0-4.25). Conclusions: Prognosis in MCS varies considerably. Metastatic disease at diagnosis has the strongest impact on survival. Complete resection and adjuvant chemotherapy should be considered as standard of care for localised disease.