Status of Surgical Margins and Prognosis in Adult Soft Tissue Sarcomas of the Extremities: A Series of Patients Treated at a Single Institution

Gronchi, Alessandro; Casali, Paolo G.; Mariani, Luigi; Miceli, Rosalba; Fiore, Marco; Vullo, Salvatore Lo; Bertulli, Rossella; Collini, Paola; Lozza, Laura; Olmi, P.; Rosaí, Juan

doi:10.1200/jco.2005.04.160

Cited by 247 publications

(170 citation statements)

References 29 publications

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“…In this review, for example, the 5-year OS rate was about 50% for retroperitoneal liposarcoma (33% FNCLCC grade 3) (Lee et al, 2011), whereas the 53-month OS rate was 93% for extremity liposarcoma (11% high grade) (Ng and Tan, 2009). The quality of surgery also plays a key role in survival outcomes (Stojadinovic et al, 2002;Gronchi et al, 2005) and may have differed across, and possibly within, the centres of the included studies. In addition, access to radiotherapy or chemotherapy agents may have been limited in some of the study countries; however, most publications were from countries (Australia, Korea, and Taiwan) where access to these treatments is unlikely to be a major issue.…”

Section: Discussionmentioning

confidence: 99%

Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

Ngan¹,

Wang²,

Porter³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 14 (11), [6821][6822][6823][6824][6825][6826][6827][6828][6829][6830][6831][6832] Introduction Soft-tissue sarcomas (STS) are a heterogeneous group of rare tumours. More than 50 STS histotypes have been identified, with most having unique clinical, prognostic, and therapeutic features. Although less than 1% of all adult malignant tumours are STS (Fletcher et al., 2002a), their treatment and management is complex because many tumour-related (eg, histotype, site, size, depth, grade, primary vs recurrent) (Singer et al., 1994;2000;Pisters et al., 1996) and treatment-related (eg, surgical margins, use of adjuvant therapy) (Singer et al., 2000) factors influence patient outcomes. Because these factors are inherently variable and because STS is rare, the management of patients with STS is best undertaken by an experienced multidisciplinary team in specialist centres to minimise recurrence, maximise survival, and preserve functionality and quality of life (Ray-Coquard et al., 2004;Luis et al., 2010; National Comprehensive Cancer Network, 2012).The standard primary treatment for STS is surgical AbstractBackground: Soft-tissue sarcomas require tailored and multidisciplinary treatment and management. However, little is known about how sarcomas are treated and managed throughout the Asia-Pacific region. Materials and Methods: MEDLINE was systematically searched using prespecified criteria. Publications (previous 10 years) that reported tumour characteristics, treatment patterns, survival outcomes, and/or safety outcomes of patients with soft-tissue sarcoma were selected. Exclusion criteria were studies of patients <18 years of age; ≤10 patients; countries other than Australia, Hong Kong, Indonesia, Korea, Malaysia, New Zealand, Philippines, Singapore, Taiwan, or Thailand; >20% benign tumours; sarcomas located in bones or joints; gastrointestinal stromal tumour; Kaposi's sarcoma; or not reporting relevant outcomes. Results: Of the 1,822 publications retrieved, 35 (32 studies) were included. Nearly all patients (98%, 1,992/2,024; 31 studies) were treated with surgery, and more studies used adjuvant radiotherapy than chemotherapy (24 vs 17 studies). Survival outcomes and recurrence rates varied among the studies because of the different histotypes, sites, and disease stages assessed. Only 5 studies reported safety findings. Conclusions: These findings highlight the lack of specific data available about soft-tissue sarcomas in the Asia-Pacific region. Better efforts to understand how the sarcoma is managed and treated will help improve patient outcomes in the region.

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Section: Discussionmentioning

confidence: 99%

Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

Ngan¹,

Wang²,

Porter³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Finally, we could not qualitatively evaluate the margins. The importance of qualitative margin, or barrier, has been considered by sarcoma surgeons [7,10] and attempts have been made to assign quantitative values to anatomic barriers [10]. The difficulty associated with retrospectively evaluating the quality of the margin, as well as the multitude of confounding factors, has prevented meaningful data regarding the quality of the margin and its impact on local recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…Soft tissue sarcomas of the extremities are a heterogeneous group of neoplasms that arise from mesenchymal tissue and represent approximately 1% of all cancers [7,13,19]. Soft tissue sarcomas require a wide surgical resection margin consisting of the pseudocapsule and a cuff of normal tissue around the tumor to minimize the risk for local recurrence [19,22,24,26].…”

Section: Introductionmentioning

confidence: 99%

Extremity Soft Tissue Sarcoma Resections: How Wide Do You Need to Be?

King

Hackbarth

Kirkpatrick

2012

Clinical Orthopaedics &Amp; Related Research

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Background Sarcomas require a wide margin of resection including a cuff of normal tissue to minimize the risk of local recurrence. The amount of tissue that constitutes a wide margin is unclear in the literature. Questions/purposes We therefore determined whether a close resection margin for soft tissue sarcoma resulted in an increased incidence of locally recurrent disease and whether additional factors, including radiation therapy, outside biopsies, and tumor biology, affected the risk of local recurrence. Methods We retrospectively reviewed 117 patients with soft tissue sarcomas resected with negative margins from 2001 to 2007. Gross specimens were inked and the closest macroscopic margins were sent for microscopic examination. Resection margins were categorized as less than 1 mm, 1-5 mm, or greater than 5 mm. We evaluated additional factors that might influence local recurrence, including radiation therapy, outside biopsies, sarcoma type, grade, and stage at presentation, and development of metastatic disease.

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“…Therefore, patients who had positive surgical margins had a greater risk of dying mainly from locoregional disease independent of tumor location, as reported in other series of patients with softtissue sarcoma. [17][18][19][20][21] Two more factors had an affect on recurrencefree survival in our series: tumor location and the administration of radiation therapy. Patients who had tumors of the extremities had more favorable local control rates compared with patients who had tumors located at other sites.…”

Section: Discussionmentioning

confidence: 99%

Myxoid/round cell and pleomorphic liposarcomas

Fiore¹,

Grosso²,

Vullo³

et al. 2007

Cancer

143

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The 15–20 physiological types of retinal ganglion cells (RGCs) can be grouped according to whether they fire to increased illumination in the receptive‐field center (ON cells), decreased illumination (OFF cells), or both (ON‐OFF cells). The diversity of RGCs has been best described in the rabbit retina, which has three types of ON‐OFF RGCs with complex receptive‐field properties: the ON‐OFF direction‐selective ganglion cells (DSGCs), the local edge detectors, and the uniformity detectors. Here we describe a novel type of bistratified ON‐OFF RGC that has not been described in either physiological or morphological studies of rabbit RGCs. These cells stratify in the ON and OFF sublaminae of the inner plexiform layer, branching at about 30% and 60% depth, between the ON and OFF arbors of the bistratified DSGCs. Similar to the ON‐OFF DSGCs, these cells respond with transient firing to both bright and dark spots flashed in the receptive field but, unlike the DSGCs, they show no directional preference for moving stimuli. We have termed these cells “transient ON‐OFF” RGCs. Area‐response measurements show that both the ON and the OFF spike responses have an antagonistic receptive‐field organization, but with different spatial extents. Voltage‐clamp recordings reveal transient excitatory inputs at light ON and light OFF; this excitation is strongly suppressed by surround stimulation, which also elicits direct inhibitory inputs to the cells at light ON and light OFF. Thus the receptive‐field organization is mediated both within the presynaptic circuitry and by direct feed‐forward inhibition. J. Comp. Neurol. 519:3128–3138, 2011. © 2011 Wiley‐Liss, Inc.

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Status of Surgical Margins and Prognosis in Adult Soft Tissue Sarcomas of the Extremities: A Series of Patients Treated at a Single Institution

Cited by 247 publications

References 29 publications

Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

Extremity Soft Tissue Sarcoma Resections: How Wide Do You Need to Be?

Myxoid/round cell and pleomorphic liposarcomas

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