scholarly journals High-grade soft tissue sarcomas of the extremities: surgical margins influence only local recurrence not overall survival

2015 ◽  
Vol 39 (5) ◽  
pp. 935-941 ◽  
Author(s):  
Julie Willeumier ◽  
Marta Fiocco ◽  
Remi Nout ◽  
Sander Dijkstra ◽  
William Aston ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcomas ◽  
Surgical Margins ◽  
High Grade

Treatment-Induced Pathologic Necrosis: A Predictor of Local Recurrence and Survival in Patients Receiving Neoadjuvant Therapy for High-Grade Extremity Soft Tissue Sarcomas

2001 ◽  
Vol 19 (13) ◽  
pp. 3203-3209 ◽  
Author(s):  
Fritz C. Eilber ◽  
Gerald Rosen ◽  
Jeffery Eckardt ◽  
Charles Forscher ◽  
Scott D. Nelson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Neoadjuvant Therapy ◽  
Independent Predictor ◽  
Survival Rates ◽  
Soft Tissue Sarcomas ◽  
High Grade ◽  
Recurrence Rates ◽  
Pathologic Assessment

PURPOSE: To determine whether treatment-induced pathologic necrosis correlates with local recurrence and overall survival in patients who receive neoadjuvant therapy for high-grade extremity soft tissue sarcomas. PATIENTS AND METHODS: Four hundred ninety-six patients with intermediate- to high-grade extremity soft tissue sarcomas received protocol neoadjuvant therapy. All patients underwent surgical resection after neoadjuvant therapy and had pathologic assessment of tumor necrosis in the resected specimens. RESULTS: The 5- and 10-year local recurrence rates for patients with ≥ 95% pathologic necrosis were significantly lower (6% and 11%, respectively) than the local recurrence rates for patients with less than 95% pathologic necrosis (17% and 23%, respectively). The 5- and 10-year survival rates for the patients with ≥ 95% pathologic necrosis were significantly higher (80% and 71%, respectively) than the survival rates for the patients with less than 95% pathologic necrosis (62% and 55%, respectively). Patients with less than 95% pathologic necrosis were 2.51 times more likely to develop a local recurrence and 1.86 times more likely to die of their disease as compared with patients with ≥ 95% pathologic necrosis. The percentage of patients who achieved ≥ 95% pathologic necrosis increased to 48% with the addition of ifosfamide as compared with 13% of the patients in all the other protocols combined. CONCLUSION: Treatment-induced pathologic necrosis is an independent predictor of both local recurrence and overall survival in patients who receive neoadjuvant therapy for high-grade extremity soft tissue sarcomas. A complete pathologic response (≥ 95% pathologic necrosis) correlated with a significantly lower rate of local recurrence and improved overall survival.

scholarly journals The Effect of Resection Margin on Local Recurrence and Survival in High Grade Soft Tissue Sarcoma of the Extremities: How Far Is Far Enough?

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2560
Author(s):  
Annika Bilgeri ◽  
Alexander Klein ◽  
Lars H. Lindner ◽  
Silke Nachbichler ◽  
Thomas Knösel ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Resection Margin ◽  
Soft Tissue Sarcomas ◽  
High Grade ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Positive Margins ◽  
Local Recurrence Free Survival

Background: The significance of surgical margins after resection of soft tissue sarcomas in respect to local-recurrence-free survival and overall survival is evaluated. Methods: A total of 305 patients with deep-seated, G2/3 soft tissue sarcomas (STS) of the extremity, the trunk wall, or the pelvis were reviewed. The margin was defined according to the Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) classification system (R0-2), the Union Internationale Contre le Cancer (UICC) classification (R + 1 mm) for which a margin <1 mm is included into the R1 group, and in groups of <1 mm, 1–5 mm, >5 mm, or >10 mm. Results: Of these patients, 31 (10.2%) had a contaminated margin, 64 (21%) a margin of <1 mm, 123 (40.3%) a margin of 1–5 mm, 47 (15.4%) a margin of >5 mm, and 40 (13.1%) a margin of >10 mm. The 5-year local recurrence-free survival (LRFS) was 81.6%. Overall survival (OS) at 5 years was 65.9%. Positive margins worsened LRFS and OS. A margin of >10 mm did not improve LRFS and OS as compared to one of >5 mm. Conclusions: A resection margin of <1 mm showed a trend but not significantly better LRFS or OS compared to a contaminated margin. This finding supports use of the UICC classification. A margin of more than 10 mm did not improve LRFS or OS.

Myxofibrosarcoma: clinical and prognostic value of MRI features

2020 ◽  
Vol 16 ◽  
Author(s):  
Paolo Spinnato ◽  
Andrea Sambri ◽  
Tomohiro Fujiwara ◽  
Luca Ceccarelli ◽  
Roberta Clinca ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Contrast Enhancement ◽  
Imaging Modality ◽  
Soft Tissue Sarcomas ◽  
The Elderly ◽  
High Rate ◽  
Imaging Features ◽  
High Grade ◽  
Mri Features

: Myxofibrosarcoma is one of the most common soft tissue sarcomas in the elderly. It is characterized by an extremely high rate of local recurrence, higher than other soft tissue tumors, and a relatively low risk of distant metastases.Magnetic resonance imaging (MRI) is the imaging modality of choice for the assessment of myxofibrosarcoma and plays a key role in the preoperative setting of these patients.MRI features associated with high risk of local recurrence are: high myxoid matrix content (water-like appearance of the lesions), high grade of contrast enhancement, presence of an infiltrative pattern (“tail sign”). On the other hand, MRI features associated with worse sarcoma specific survival are: large size of the lesion, deep location, high grade of contrast enhancement. Recognizing the above-mentioned imaging features of myxofibrosarcoma may be helpful to stratify the risk for local recurrence and disease-specific survival. Moreover, the surgical planning should be adjusted according to the MRI features

Predictors of Local Recurrence in High-grade Soft Tissue Sarcomas: Hydrogen Peroxide as a Local Adjuvant

Orthopedics ◽  
2013 ◽  
Vol 36 (2) ◽  
pp. e207-e215 ◽  
Author(s):  
Adam N. Wooldridge ◽  
Gregory P. Kolovich ◽  
Martha K. Crist ◽  
Joel L. Mayerson ◽  
Thomas J. Scharschmidt
Keyword(s):  
Hydrogen Peroxide ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcomas ◽  
High Grade

The effect of local recurrence on survival time in adult high-grade soft tissue sarcomas

1989 ◽  
Vol 42 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Lawrence J. Emrich ◽  
Wlodzimierz Ruka ◽  
Deborah L. Driscoll ◽  
Constantine P. Karakousis
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Survival Time ◽  
Soft Tissue Sarcomas ◽  
High Grade

Surgical margins, local recurrence and metastasis in soft tissue sarcomas

2000 ◽  
Vol 36 (6) ◽  
pp. 710-716 ◽  
Author(s):  
C.S. Trovik ◽  
H.C.F. Bauer ◽  
T.A. Alvegård ◽  
H. Anderson ◽  
C. Blomqvist ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcomas ◽  
Surgical Margins

scholarly journals What Are Risk Factors for Local Recurrence of Deep High-grade Soft-tissue Sarcomas?

2011 ◽  
Vol 470 (3) ◽  
pp. 700-705 ◽  
Author(s):  
Chigusa Sawamura ◽  
Seiichi Matsumoto ◽  
Takashi Shimoji ◽  
Taisuke Tanizawa ◽  
Keisuke Ae
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcomas ◽  
High Grade

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

2005 ◽  
Vol 23 (1) ◽  
pp. 96-104 ◽  
Author(s):  
A. Gronchi ◽  
P.G. Casali ◽  
L. Mariani ◽  
R. Miceli ◽  
M. Fiore ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcomas ◽  
Hazard Ratio ◽  
Surgical Margins ◽  
Prognostic Impact ◽  
Positive Surgical Margins ◽  
Positive Margins ◽  
Prognostic Effect ◽  
Marginal Status

Purpose To explore the prognostic effect of microscopic marginal status after surgery for extremity soft tissue sarcomas. Patients and Methods We analyzed 911 consecutive patients surgically treated throughout a 20-year span at a single referral center. Six hundred forty-two were first seen with a primary tumor, and 269, with a locally recurrent tumor. All patients underwent macroscopically complete resection. Microscopic marginal status was negative (tumor size > 1 mm) in 748 patients and positive (≤ 1 mm) in 163 patients. Median follow-up was 107 months. Results Patients with primary disease had a lower disease-specific mortality in comparison to those first examined for recurrence (25% v 37%, respectively, at 10 years). Size, malignancy grade, depth, histotype, and local recurrence had a statistically significant prognostic effect at multivariable analysis, while microscopically positive surgical margins had not, though a trend in favor of negative margins was observed. However, an extra risk was observed for patients with positive margins after 3 to 5 years (hazard ratio, 1.8 after 5 years v 0.8 before 5 years). In patients treated for a local recurrence, the prognostic impact of positive margins was higher (hazard ratio, 1.6). Conclusion Positive surgical margins had a weak adverse prognostic effect, which was more pronounced for those patients escaping an early relapse. This would seem to justify a policy of surgical adequacy in adult soft tissue sarcomas, though clinical decision making in borderline presentations for conservative surgery might be reasonably flexible and shared with the patient. Once a local relapse has occurred, the impact of local treatments seems more critical.

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