Low-grade soft-tissue sarcomas: What is an adequate margin for local disease control?

Abstract INTRODUCTION Laser Interstitial thermal therapy (LITT) is a minimal-access procedure for intracranial tumors that are either refractory to standard treatment paradigms or difficult to access via conventional open surgery. OBJECTIVE To evaluate predictors of local disease control following LITT in patients with primary and secondary brain tumors. METHODS Single-center retrospective cohort study of all consecutive LITT ablations between 2014 and 2019. Demographic and procedural characteristics analyzed with respect to local disease control at 6 months. Chi-square tests for categorical variables, T-tests/Wilcoxon Rank-Sum tests for continuous variables for parametric and non-parametric data, respectively. Poisson regression models were used to approximate relative risk (RR) with 95% confidence intervals. RESULTS A total of 76 patients underwent LITT with a median follow up of 12.3 months; pathology at time of ablation was glioblastoma multiforme (GBM, 36%), WHO grade III primary CNS (24%), low grade CNS (20%), and metastatic lesions (19%) with respective local control rates of 26%, 20%, 29%, and 26%. Pathology of GBM (RR 0.46, 0.21-1.02, p=0.055) and a 5-year increase in age at the time of ablation (RR 0.91, 0.83-0.99, p=0.028) were associated with a lower likelihood of local control at 6 months. Preoperative Karnofsky performance status (KPS) of 100 (RR 2.04, 1.13-3.69, p=0.019) was associated with a higher likelihood of local control. Extent of ablation (EOA) demonstrated a direct relationship with local control; when EOA=100% local control was 59%, with this rate dropping down to 21% when EOA=90%. Tumor location, lesion volume, gender, BMI, ethnicity, or whether there existed multiple foci of disease at the time of ablation had no strong association with local control. CONCLUSION Our series demonstrates that preoperative performance status and age were strong predictors of local disease control following LITT. Incomplete ablation and histology of high-grade glioma portended a higher risk of local recurrence.

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Long-term local disease control in a recurrent soft-tissue sarcoma of the thigh treated by radiofrequency ablation

Journal of Surgical Oncology ◽

10.1002/jso.23877 ◽

2015 ◽

Vol 111 (6) ◽

pp. 708-710 ◽

Cited By ~ 3

Author(s):

Maria P. Belfiore MD ◽

Francesco M. Ronza MD ◽

Tullio Della Volpe ◽

Michela Pascale ◽

Giuseppe Belfiore

Keyword(s):

Radiofrequency Ablation ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Disease Control ◽

Local Disease ◽

Local Disease Control

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Development and External Validation of Deep-Learning-Based Tumor Grading Models in Soft-Tissue Sarcoma Patients Using MR Imaging

Cancers ◽

10.3390/cancers13122866 ◽

2021 ◽

Vol 13 (12) ◽

pp. 2866

Author(s):

Fernando Navarro ◽

Hendrik Dapper ◽

Rebecca Asadpour ◽

Carolin Knebel ◽

Matthew B. Spraker ◽

...

Keyword(s):

Deep Learning ◽

Soft Tissue ◽

Mr Imaging ◽

Characteristic Curve ◽

External Validation ◽

Soft Tissue Sarcomas ◽

Treatment Decision ◽

Receiver Operator Characteristic Curve ◽

Low Grade ◽

Tumor Grading

Background: In patients with soft-tissue sarcomas, tumor grading constitutes a decisive factor to determine the best treatment decision. Tumor grading is obtained by pathological work-up after focal biopsies. Deep learning (DL)-based imaging analysis may pose an alternative way to characterize STS tissue. In this work, we sought to non-invasively differentiate tumor grading into low-grade (G1) and high-grade (G2/G3) STS using DL techniques based on MR-imaging. Methods: Contrast-enhanced T1-weighted fat-saturated (T1FSGd) MRI sequences and fat-saturated T2-weighted (T2FS) sequences were collected from two independent retrospective cohorts (training: 148 patients, testing: 158 patients). Tumor grading was determined following the French Federation of Cancer Centers Sarcoma Group in pre-therapeutic biopsies. DL models were developed using transfer learning based on the DenseNet 161 architecture. Results: The T1FSGd and T2FS-based DL models achieved area under the receiver operator characteristic curve (AUC) values of 0.75 and 0.76 on the test cohort, respectively. T1FSGd achieved the best F1-score of all models (0.90). The T2FS-based DL model was able to significantly risk-stratify for overall survival. Attention maps revealed relevant features within the tumor volume and in border regions. Conclusions: MRI-based DL models are capable of predicting tumor grading with good reproducibility in external validation.

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Stereotactic radiosurgery for cerebral metastatic melanoma: factors affecting local disease control and survival

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/s0360-3016(98)00272-7 ◽

1998 ◽

Vol 42 (3) ◽

pp. 581-589 ◽

Cited By ~ 175

Author(s):

Yoshimasa Mori ◽

Douglas Kondziolka ◽

John C Flickinger ◽

John M Kirkwood ◽

Sanjiv Agarwala ◽

...

Keyword(s):

Disease Control ◽

Metastatic Melanoma ◽

Stereotactic Radiosurgery ◽

Factors Affecting ◽

Local Disease ◽

Local Disease Control

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Adenoviral-Based Immunotherapy Provides Local Disease Control in an Orthotopic Murine Model of Esophageal Cancer

Journal of Immunotherapy ◽

10.1097/cji.0000000000000038 ◽

2014 ◽

Vol 37 (5) ◽

pp. 283-292 ◽

Cited By ~ 6

Author(s):

Jon G. Quatromoni ◽

Jarrod D. Predina ◽

Pratik Bhojnagarwala ◽

Ryan P. Judy ◽

Jack Jiang ◽

...

Keyword(s):

Esophageal Cancer ◽

Disease Control ◽

Murine Model ◽

Local Disease ◽

Local Disease Control

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Radiosurgery and stereotactic radiotherapy with cyberknife system for meningioma treatment

The Neuroradiology Journal ◽

10.1177/1971400917744885 ◽

2017 ◽

Vol 31 (1) ◽

pp. 18-26 ◽

Cited By ~ 10

Author(s):

Rossella Di Franco ◽

Valentina Borzillo ◽

Vincenzo Ravo ◽

Sara Falivene ◽

Francesco Jacopo Romano ◽

...

Keyword(s):

Disease Control ◽

Stereotactic Radiosurgery ◽

Local Control ◽

Stereotactic Radiotherapy ◽

Histological Grade ◽

Fractionated Stereotactic Radiotherapy ◽

Subtotal Resection ◽

Local Disease ◽

Local Disease Control ◽

The Impact

Objective The aim of this work was to evaluate the impact of stereotactic radiosurgery/fractionated stereotactic radiotherapy with the Cyberknife system on local disease control, clinical outcome and toxicity in patients with meningioma, according to the site and histological grade of lesion. From January 2013 to April 2017, 52 patients with intracranial meningiomas were treated with the Cyberknife system. Twenty-four patients had undergone previous surgery: 38% gross total resection, 10% subtotal resection; 27 patients underwent no surgery; 22 patients had a recurrence of meningioma. Methods Radiosurgery was used for lesions smaller than 2 cm, stereotactic radiotherapy for lesions larger than 2 cm, or smaller but close to a critical site such as the optical chiasm, optic pathway or brainstem. Results Local control and clinical outcomes were analysed. Median follow-up was 20 months: six patients died, one after re-surgery died from post-surgical sepsis, three from heart disease. Progression-free survival had a mean value of 38.3 months and overall survival of 41.6 months. We evaluated at 12 months 28 patients (100% local control); at 24 months 19 patients (89% local control); at 36 months nine patients (89% local control). At baseline, 44/52 patients (85%) were symptomatic: 19 visual disorders, 17 motor disorders, six hearing disorders, 10 headache and six epilepsy. Visual symptoms remained unchanged in 52%, improved in 32%, resolved in 16%. Headache was improved in 40%, resolved in 10%, unchanged in 50%. Epilepsy was resolved in 17%, unchanged in 33%, worsened in 33%. Conclusions Stereotactic radiosurgery/fractionated stereotactic radiotherapy with Cyberknife provides a good local disease control, improving visual, hearing and motor symptoms.

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Erratum to: Elevated Controlling Nutritional Status (CONUT) Score is Associated with Poor Long-term Survival in Patients with Low-grade Soft-tissue Sarcomas Treated with Surgical Resection

Clinical Orthopaedics and Related Research ◽

10.1097/corr.0000000000002019 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Yao Liang ◽

Tao Hou ◽

Yi Que ◽

Baiwei Zhao ◽

Wei Xiao ◽

...

Keyword(s):

Soft Tissue ◽

Nutritional Status ◽

Surgical Resection ◽

Soft Tissue Sarcomas ◽

Low Grade ◽

Term Survival ◽

Long Term Survival ◽

Conut Score

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Well-Differentiated Liposarcoma of The Larynx: A Case Report and Review of Literature

Journal of Biomedical and Clinical Research ◽

10.1515/jbcr-2016-0013 ◽

2016 ◽

Vol 9 (1) ◽

pp. 85-89

Author(s):

Svetlana A. Mateva ◽

Margarita R. Nikolova ◽

Alexandar V. Valkov ◽

Margarita R. Nikolova

Keyword(s):

Case Report ◽

Soft Tissue ◽

Soft Tissue Sarcomas ◽

World Health ◽

Low Grade ◽

Review Of Literature ◽

Grade Malignancy ◽

Well Differentiated ◽

Health Organization ◽

Histologic Types

Summary Liposarcoma is one of the most common soft tissue sarcomas in adults with a relative incidence amongst other sarcomas ranging from 9.8% to 16%. It usually locates in the limbs and retroperitoneum. Primary liposarcomas of the larynx and hypopharynx are rare, comprising less than 20% of all head and neck liposarcomas. According to World Health Organization, these tumors are divided into four histologic types, and well-differentiated liposarcoma is the most common one. It is a tumor of low-grade malignancy that may recur locally, but does not metastasize. We present a case of laryngopharyngeal well- differentiated liposarcoma in an old patient with two previous removals. We also discuss recently published cases with this unusual location of liposarcoma.

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PET–CT for the diagnosis and treatment of primary musculoskeletal tumors in Chinese patients - experience from 255 patients in a single center

British Journal of Radiology ◽

10.1259/bjr.20210785 ◽

2021 ◽

Author(s):

Aikeremujiang Muheremu ◽

Tianlin Wen ◽

Xiaohui Niu

Keyword(s):

Soft Tissue ◽

Case Series ◽

Soft Tissue Sarcomas ◽

Standardized Uptake Value ◽

Chinese Patients ◽

Histopathological Study ◽

Low Grade ◽

High Grade ◽

Musculoskeletal Tumors ◽

Pet Ct

Objective: The current study was carried out to assess the value of positron emission tomography (PET)/CT on the diagnosis and staging of primary musculoskeletal tumors. Methods: PET–CT test results and histopathological study reports of all the patients with primary musculoskeletal tumors in our department from January 2006 to July 2015 were retrospectively reviewed. Maximum standardized uptake value (SUVmax) in these PET–CT reports were recorded and analyzed respectively for each type of sarcoma. Results: A total of 255 patients were included in the final analysis. Sensitivity of SUVmax based diagnosis was 96.6% for primary malignant osseous sarcomas and 91.2% for soft tissue sarcomas. SUVmax of high-grade osseous sarcomas (average 8.4 ± 5.5) was significantly higher (p < 0.001) than low-grade osseous sarcomas (average 3.9 ± 1.8); based on current case series, SUVmax of high-grade soft tissue sarcomas (7.5 ± 5.1) was not significantly different (p = 0.229) from that of low-grade soft tissue sarcomas (5.3 ± 3.7). Significant decrease of SUVmax value after chemotherapy was associated with favorable prognosis in patients with osteosarcoma. Conclusion: Results of the current study indicate that, the SUVmax based application of PET–CT can be a valuable supplementary method to histopathological tests regarding the diagnosis and staging of primary musculoskeletal sarcomas. Advances in knowledge: SUVmax based application of PET–CT is a highly sensitive method in diagnosis of primary osseous and soft tissue sarcomas in Chinese patients.

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