Abstract:The delay in surgical resection necessary to complete preoperative radiation does not seem to increase the risk of lethal metastatic spread. The risk of local recurrence may be lower after preoperative radiation. These findings must be interpreted with caution because of the heterogeneity and bias in the available studies.
“…29 In our case, quality assessment was performed using the NOS, which is purposely designed to evaluate through the use of a checklist the quality of observational studies. However, although the NOS is used in practice, 30 it was not surprising that it was more suitable for use in observational studies of an epidemiological nature rather than nonrandomized interventional studies in a surgical setting.…”
This study represents the strongest evidence (level 3a) to date that LDPs are a safe operation. However, there is still a need for randomized controlled trials to confirm this.
“…29 In our case, quality assessment was performed using the NOS, which is purposely designed to evaluate through the use of a checklist the quality of observational studies. However, although the NOS is used in practice, 30 it was not surprising that it was more suitable for use in observational studies of an epidemiological nature rather than nonrandomized interventional studies in a surgical setting.…”
This study represents the strongest evidence (level 3a) to date that LDPs are a safe operation. However, there is still a need for randomized controlled trials to confirm this.
“…MFH is considered as a tumor with higher potential to recur locally [24]. It is well accepted that positive histological margins are associated with increased rate of LR [8,17,18,25].…”
The overall prognosis is poor. LR, although can be managed with tumor re-excision, has high second recurrence rate. Increased tumor size is associated with shorter metastasis-free interval which significantly decreases survival.
“…The results from this study showed that average survival was 76% (range, 62% to 88%) in the preoperative group and 67% (range, 41% to 83%) in the postoperative group, and no significant difference between the 2 groups. 44 Limitations of our study should be acknowledged. We were not able to incorporate patient-level data in our metaanalysis and the results are from study-level data.…”
High-quality studies reporting adjusted hazard ratios are associated with improved survival in patients receiving radiotherapy for STS. Studies in which odds ratios are calculated from event data and those that do not report adjusted outcomes do not show the same association, likely due to confounding by indication.
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