Soft tissue sarcomas of the buttock: A systematic review and meta-analysis

Sacco, Riccardo; Lalevée, Matthieu; Pellegrino, P.; Ferro, A.; Yasmine, Bendoukha; André, Gillibert; Gilleron, Matthieu; Hamza, Amine; Piana, Raimondo; Dujardin, F.

doi:10.1016/j.suronc.2022.101883

Cited by 3 publications

(13 citation statements)

References 51 publications

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“…This small case series con rms previous ndings, peculiar of BSTS, such as a high-rate of LR [5]. BSTS seems to shares several characteristics similar to pelvic STS, instead of extremities STS [4]: the surgical treatment of BSTS presents the challenges associated with the complex anatomy of the pelvis, such as the lack of true fascial compartments seen in the extremities, the prevalence of high-grade lesions, and large size of the tumors at the time of diagnosis, which is often delayed [4,5,24]. In the surgical treatment of BSTS, the achievement of wide margins is di cult.…”

Section: Discussionsupporting

confidence: 90%

“…We evaluated the treatment and outcomes of high-grade BSTS over a 5-year period, in a high-volume facility specialized in musculoskeletal oncology, that has been shown to improve patients survival and functional outcomes after a diagnosis of soft tissue sarcoma [24]. To our knowledge, there are only four retrospective consecutive case series of patients treated for BSTS [2,3,5,6] with heterogeneous surgical and non-surgical treatments, including both high and low-grade STS such as well-differentiated liposarcomas.…”

Section: Discussionmentioning

confidence: 99%

“…In this series, three out of nine patients were referred after unplanned excision: despite numerous publications and years of education on the importance of proper evaluation of soft tissue masses, it is clear that an effort to educate clinicians is still needed. The clinical presentation of BSTS is insidious, with mass detection in the gluteal area as the most common symptom reported [4][5][6][7][8][9][10]. Buttock pain or sciatica is less frequent and delayed, often associated with advanced disease at the time of diagnosis, and large, deep-seated lesions [5].…”

Section: Discussionmentioning

confidence: 99%

“…Current approaches to BSTS include surgical resection (i.e. buttectomy) and radiation therapy, while the role of chemotherapy is still unclear [5]. To date, the literature concerning BSTS includes single-center retrospective case series [4,[6][7][8][9][10], and case reports [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…We have assisted an increased anatomical knowledge of the deep gluteal space along with new surgical techniques for resection of sciatic notch tumors with a combined posterior and anterior approach [16]. The need of new research in this area was emphasized in a recent meta-analysis [5], that found high rates of local recurrence and distant metastases, and a poor pooled 5-year overall survival (41%, IC95%: 33-49%) for patients treated between 1948 and 2002, compared to the survival of extremities and trunk STS during the same period.. Our objective was to determine whether current treatment yields reasonable oncological outcomes. We analyzed the management and clinical outcome of a consecutive series of patients treated for high-grade BSTS from 2016 to 2021, and presented a detailed surgical technique of buttectomy.…”

Section: Introductionmentioning

confidence: 99%

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High-grade soft tissue sarcomas of the buttock: a case series and surgical technique

Sacco

Piana

Pellegrino

et al. 2023

Preprint

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Objective Soft tissue sarcomas of the buttock (BSTS) are historically associated with a poor prognosis. The literature concerning BSTS includes outdated single-center retrospective case series, and case reports. We aimed to analyze the oncologic outcomes of high-grade BSTS according to current treatment modalities, and to present a detailed surgical technique of buttectomy,. Methods Consecutive patients diagnosed with BSTS from 2016 to 2021, were retrospectively evaluated for the rate of local control, distant metastases, overall survival (OS) and disease-free survival (DFS). Inclusion criteria: (1) high-grade STS confirmed by pathological biopsy, (2) tumors localized to the buttock, (3) surgical treatment, (4) age > 18 years. All patients underwent surgical resection. Chemotherapy and/or radiation therapy was administered according to a standardized protocol. Functional outcome was assessed with the Musculoskeletal Tumor Society score (MSTS 1993). Results Nine high-grade, G2/3 BSTS were included; mean age 60.1 years (range, 30–86), and mean follow-up 4,5 years (range, 1–7). There were 7 undifferentiated pleomorphic sarcoma, 1 fibrosarcoma, and 1 myxoid liposarcoma. Three patients were referred after whoops surgeries, 33% (3/9). Overall, the deep gluteal space was invaded in three out of nine patients, and the subcutaneous fat in another three out of nine patients; wide margins were achieved only in two patients. At the last follow-up, two patients developed distant metastasis and died, in one case with invasion of the deep gluteal space, and in another of the subcutaneous fat; 7/9 patients were alive and disease-free. The LR rate was 33% (2/6), the 5-year OS and DFS were 66% (5/7). The MSTS 1987 scores averaged 89.0 (range 76–100). Conclusion BSTS are still associated with high rates of whoops surgeries and local recurrence in agreement with previous evidence from 1948 to 2002. Buttectomy for high-grade BSTS provided acceptable oncological outcomes when performed by a trained team using a precise surgical technique, in association to a multimodal therapy.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High-grade soft tissue sarcomas of the buttock: a case series and surgical technique

Sacco

Piana

Pellegrino

et al. 2023

Preprint

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The devastating impact of unresectable infectious undifferentiated pleomorphic sarcoma in the gluteal region: A case report

Goli,

Torabzadeh,

Hassanpour

et al. 2024

International Journal of Surgery Case Reports

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A Case of a Chronic Expanding Hematoma Caused by an Epidermal Cyst

Kuwahara

Wada

Masuda

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Chronic expanding hematoma (CEH) is a rare type of hematoma that expands slowly and continuously without compromising coagulation. Its etiology is often unknown. However, we experienced a rare case of CEH, in which an epidermal cyst was thought to be the cause. A 57-year-old man had developed a painless soft-tissue tumor in his left buttock 45 years earlier, which slowly grew to 11 cm in diameter. Preoperative magnetic resonance imaging suggested a large cyst containing several masses. Surgery revealed a hematoma and keratin debris surrounded by a white fibrous cyst wall and a fibrous nodule measuring 4 cm in diameter. On histopathological examination of the white fibrous wall, an epidermal component was observed contralateral to the superficial punctum, but the epidermal component was absent from most of the wall, including the fibrous nodule. Based on a pathological examination, the CEH was suggested to have been caused by partial rupturing and inflammation of an epidermal cyst. To the best of our knowledge, there are no reports of epidermal cysts causing CEH. In addition, the large fibrous nodule protruding from the CEH cyst wall was considered to be rare. This was considered to be a rare CEH that may have originated from an epidermal cyst.

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Soft tissue sarcomas of the buttock: A systematic review and meta-analysis

Cited by 3 publications

References 51 publications

High-grade soft tissue sarcomas of the buttock: a case series and surgical technique

High-grade soft tissue sarcomas of the buttock: a case series and surgical technique

The devastating impact of unresectable infectious undifferentiated pleomorphic sarcoma in the gluteal region: A case report

A Case of a Chronic Expanding Hematoma Caused by an Epidermal Cyst

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