Soft tissue sarcoma of the hand: Is unplanned excision a problem?

Lans, Jonathan; Yue, Kai-Lou C; Castelein, René M.; Chen, Neal C.; Lozano-Calderón, Santiago

doi:10.1016/j.ejso.2019.03.024

Cited by 8 publications

(8 citation statements)

References 40 publications

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“…The intention of the R system is to be more reproducible and objective and it is widely used (Gundle et al., 2018). Positive surgical margins (R1) were predictive of local recurrence in our study, confirming large studies on STS in general (Pisters et al., 1996; Stojadinovic et al., 2002) and other studies on hand STS (Lans et al., 2019; Pradhan et al., 2008). Yet, there was no significant impact of margin status on metastasis-free survival or disease-specific survival.…”

Section: Discussionsupporting

confidence: 91%

“…Most tumours were high-grade, and as in other studies, epitheloid sarcoma and synovial sarcoma were among the most frequent histologic subtypes (Houdek et al., 2017; Lans et al., 2019). Tumour size was also identified as an important overall prognostic factor and predictive of local recurrence-free survival, metastasis-free survival, and disease-specific survival, which also has been reported previously (Houdek et al., 2017; Lans et al., 2019). They reported wide excision of 41 out of 46 hand STSs, of which six were transradial amputations and 19 were single or multiple ray amputations.…”

Section: Discussionsupporting

confidence: 79%

“…At a mean follow-up of 5 years they reported a local-recurrence-free survival of 86%, metastasis-free survival of 66%, and overall survival of 78%. In a study by Lans et al. (2019) of 64 hand with STS, of which 83% were referred after external unplanned excision, amputations were performed in approximately 44% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…(2019) of 64 hand with STS, of which 83% were referred after external unplanned excision, amputations were performed in approximately 44% of cases. They reported a 5-year disease-free survival of 69% and 5-year overall survival of 82% after a median follow-up of 4 years (Lans et al., 2019). Pradhan et al.…”

Section: Discussionmentioning

confidence: 99%

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Limb preserving surgery for soft-tissue sarcoma in the hand: a retrospective study of 51 cases

Dadras

Steinau

Goertz

et al. 2020

J Hand Surg Eur Vol

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Our retrospective study analysed the long-term results of a conservative limb-preserving surgical strategy in 51 patients with soft-tissue sarcoma of the hand from a single institution. We assessed survival and prognostic factors, including the surgical margins. No transradial amputations were performed. Microscopically free resection margins were obtained in 45 of the patients. The remaining six patients had microscopically incomplete resection. Forty-four surviving patients had a median follow-up of 6.5 years (range 12–307), and one patient had no follow-up beyond 3 months following surgery. Among those patients, 29 had more than 5 years of follow-up. Five-year local-recurrence-free survival was 65%, metastasis-free survival was 84%, and disease-specific survival was 91%. Tumour size was predictive of all outcome parameters, but positive resection margins adversely affected local recurrence only. Survival was similar to the survival after a more radical surgical approach reported in the literature. Level of evidence: IV

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Limb preserving surgery for soft-tissue sarcoma in the hand: a retrospective study of 51 cases

Dadras

Steinau

Goertz

et al. 2020

J Hand Surg Eur Vol

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“…In the upper extremity, tumors are in close proximity to neurovascular structures vital for function. A multidisciplinary approach in specialized oncology centers has shown to optimize both oncologic and functional results 2–9 …”

Section: Introductionmentioning

confidence: 99%

Factors associated with 30‐day soft tissue complications following upper extremity sarcoma surgery

Hoftiezer

Lans

Freniere

et al. 2020

Journal of Surgical Oncology

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Background and ObjectivesThe incidence of soft tissue complications following sarcoma surgery in the upper extremity is reportedly high. Therefore, this study assessed the National Surgical Quality Improvement Program (NSQIP) database to identify independent risk factors, while also reporting the incidence of soft tissue complications in the first 30 days after surgery.MethodsA total of 620 patients that underwent surgical treatment for upper extremity sarcoma were included from the NSQIP database. Soft tissue complications were defined as surgical site infection, wound dehiscence, or soft‐tissue related reoperations. Clinically relevant patient and treatment characteristics were selected and analyzed.ResultsThe 30‐day soft tissue complication rate was 4.7%. In the multivariable analysis, higher body mass index (p = .047) and longer operative times (p = .002) were independently associated with soft tissue complications.ConclusionsHigher body mass index and longer operative times are risk factors for soft tissue complications following upper extremity sarcoma surgery. The soft‐tissue complication rate following resection of upper extremity tumors is low in this national cohort, possibly due to the relatively small tumor size and low prevalence of radiotherapy.

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Surgery at specialised sarcoma centres improves patient outcomes – A systematic review by the Australia and New Zealand sarcoma association clinical practice guidelines working party

Hong

Sundaram

Perianayagam

et al. 2023

European Journal of Surgical Oncology

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Soft tissue sarcoma of the hand: Is unplanned excision a problem?

Cited by 8 publications

References 40 publications

Limb preserving surgery for soft-tissue sarcoma in the hand: a retrospective study of 51 cases

Limb preserving surgery for soft-tissue sarcoma in the hand: a retrospective study of 51 cases

Factors associated with 30‐day soft tissue complications following upper extremity sarcoma surgery

Surgery at specialised sarcoma centres improves patient outcomes – A systematic review by the Australia and New Zealand sarcoma association clinical practice guidelines working party

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