A systematic review of margin status in retroperitoneal liposarcomas: Does the R0 margin matter?

Paik, Benjamin; Seo, Chin Jin; Tan, Joey Wee-Shan; Juan, Wen Kai Darryl; Soo, Khee Chee; Ong, Chin-Ann Johnny; Chia, Claramae Shulyn; Wong, Jolene Si Min

doi:10.3389/fonc.2022.891710

Cited by 8 publications

(7 citation statements)

References 81 publications

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“…There was no signi cant difference in tumor grade between the groups (p = 0.133), and Grades I-III were all present in each group. Since the signi cance of microscopic margin is unclear despite some evidence for better outcomes with R0 than with R1 resections [19], we have selected the rate of R2 resection as a meaningful marker of resection margin. R0/1 resection was achieved in more than 85% of the cases in all groups, and the rate of R2 resection showed no statistically signi cant difference between the groups.…”

Section: Histopathologymentioning

confidence: 99%

Feasibility and advantage of pre-operative radiotherapy in retroperitoneal sarcoma

Park

Yoo

et al. 2023

Preprint

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Background A high rate of locoregional recurrence is one of the major difficulties in successful treatment of retroperitoneal sarcoma (RPS). Although pre-operative radiotherapy (preRTx) is considered a potential way to improve local recurrence, concerns about the associated treatment toxicity and risk of peri-operative complications need to be addressed. Hence, this study investigates the safety of pre-operative radiotherapy for RPS. Methods A cohort of 198 patients with RPS who had undergone both surgery and radiotherapy was analyzed for peri-operative complications. They were divided into three groups according to the radiotherapy scheme: 1) preRTx group, 2) post-operative radiotherapy without tissue expander, and 3) post-operative radiotherapy with tissue expander. Results The preRTx was overall well tolerated and did not affect the R2 resection rate, operative time, and severe post-operative complications. However, the preRTx group was associated with higher incidence of post-operative transfusion and admission to intensive care unit (p = 0.013 and p = 0.036, respectively), where preRTx was an independent risk factor only for the post-operative transfusion (p = 0.009) in multivariate analysis. The median radiation dose was the highest in preRTx group, although no significant difference was demonstrated in overall survival and local recurrence rate. Conclusion This study suggests that the preRTx does not add significant post-operative morbidity to the patients with RPS. In addition, radiation dose elevation is achievable with the pre-operative radiotherapy. However, a meticulous intra-operative bleeding control is recommended in those patients, and further high-quality trials are warranted to evaluate the long-term oncological outcomes.

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Section: Histopathologymentioning

confidence: 99%

Feasibility and advantage of pre-operative radiotherapy in retroperitoneal sarcoma

Park

Yoo

et al. 2023

Preprint

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“…There was no significant difference in tumor grade between the groups ( p = 0.133), and Grades I–III were all present in each group. Since the significance of microscopic margin is unclear despite some evidence for better outcomes with R0 than with R1 resections ( 19 ), we have selected the rate of R2 resection as a meaningful marker of resection margin. R0/1 resection was achieved in more than 85% of the cases in all groups, and the rate of R2 resection showed no statistically significant difference between the groups.…”

Section: Resultsmentioning

confidence: 99%

Effect of pre-operative radiation therapy on surgical outcome in retroperitoneal sarcoma

Park

Yoo

et al. 2023

Front. Surg.

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BackgroundA high rate of locoregional recurrence is one of the major difficulties in successful treatment of retroperitoneal sarcoma (RPS). Although pre-operative radiation therapy (RT) is considered a potential way to improve local recurrence, concerns about the associated treatment toxicity and risk of peri-operative complications need to be addressed. Hence, this study investigates the safety of pre-operative RT (preRTx) for RPS.MethodsA cohort of 198 patients with RPS who had undergone both surgery and RT was analyzed for peri-operative complications. They were divided into three groups according to the RT scheme: (1) preRTx group, (2) post-operative RT without tissue expander, and (3) post-operative RT with tissue expander.ResultsThe preRTx was overall well tolerated and did not affect the R2 resection rate, operative time, and severe post-operative complications. However, the preRTx group was associated with higher incidence of post-operative transfusion and admission to intensive care unit (p = 0.013 and p = 0.036, respectively), where preRTx was an independent risk factor only for the post-operative transfusion (p = 0.009) in multivariate analysis. The median radiation dose was the highest in preRTx group, although no significant difference was demonstrated in overall survival and local recurrence rate.ConclusionThis study suggests that the preRTx does not add significant post-operative morbidity to the patients with RPS. In addition, radiation dose elevation is achievable with the pre-operative RT. However, a meticulous intra-operative bleeding control is recommended in those patients, and further high-quality trials are warranted to evaluate the long-term oncological outcomes.

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“…It is almost impossible to examine the margins of a resection specimen with a surface of more than half a square meter. Therefore, the adequacy of assessing the margins by the pathologist for R0 versus R1 is to some extent dependent from the surgeon indicating and marking the areas of risk for incomplete resection [19]. Also surgery for welldifferentiated (grading 1) liposarcomas of the extremities is frequently performed as marginal resection for their relative low biological aggressiveness and the possibility of a re-resection in case of recurrences developing over years in most cases.…”

Section: Discussionmentioning

confidence: 99%

Quality Measurement for Soft Tissue Sarcomas in Germany: First Results of the Certified Sarcoma Centres

Rückher¹,

Grießhammer²,

Langer³

et al. 2023

Oncol Res Treat

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Introduction: Soft tissue sarcomas (STS) are rare diseases. A high level of standardization and centralisation was lacking in Germany until 2018. Methods: By developing an evidence-based guideline and a certification system for sarcoma centres, foundations for structured, guideline-based and centralised sarcoma care were defined. First results of the certified Sarcoma Centres are presented. Results: The first three years of data collection show good results for case volume, presentation rates in pretherapeutic and postoperative tumor boards, psychooncological counselling and study rates. However, other indicators (e.g. preoperative or postoperative radiotherapy for operated high risk STS without GIST, counselling rates social services) still have potential for improvement. Based on these results, the set of indicators could be further improved. Conclusions: A sarcoma-specific quality assurance scheme that includes guideline-derived quality indicators was developed. In future, a broader database will allow further insights into sarcoma care in Germany.

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A systematic review of margin status in retroperitoneal liposarcomas: Does the R0 margin matter?

Cited by 8 publications

References 81 publications

Feasibility and advantage of pre-operative radiotherapy in retroperitoneal sarcoma

Feasibility and advantage of pre-operative radiotherapy in retroperitoneal sarcoma

Effect of pre-operative radiation therapy on surgical outcome in retroperitoneal sarcoma

Quality Measurement for Soft Tissue Sarcomas in Germany: First Results of the Certified Sarcoma Centres

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