Does Local Recurrence Impact Survival in Low-grade Chondrosarcoma of the Long Bones?

2007 ◽  
Vol 462 ◽  
pp. 175-180 ◽  
Author(s):  
Joseph H Schwab ◽  
Doris Wenger ◽  
Krishnan Unni ◽  
Franklin H Sim
Keyword(s):  
Local Recurrence ◽  
Low Grade ◽  
Long Bones

scholarly journals Wide Local Excision for Dermatofibrosarcoma Protuberans: A Single-Center Series of 90 Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Byung Jun Kim ◽  
Hyeonwoo Kim ◽  
Ung Sik Jin ◽  
Kyung Won Minn ◽  
Hak Chang
Keyword(s):  
Local Recurrence ◽  
Local Excision ◽  
Wide Local Excision ◽  
Safety Margin ◽  
Dermatofibrosarcoma Protuberans ◽  
Low Grade ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Incomplete Removal ◽  
Surgical Methods

Background. Dermatofibrosarcoma protuberans (DFSP), a rare low-grade sarcoma of fibroblast origin, tends to extend in a finger-like fashion beyond macroscopic tumor margins. Therefore, incomplete removal and subsequent recurrence are common. This study aimed to determine the efficacy of wide local excision (WLE) for controlling local recurrence of DFSP.Methods. The medical records of 90 DFSP patients who received WLE at our hospital between June 1992 and January 2015 were retrospectively reviewed. WLE was conducted including a 3 cm (range, 1 to 5 cm) safety margin according to tumor size, location, and recurrence status. Clinical and tumor characteristics and surgical methods were evaluated for risk factor analysis and local recurrence-free survival.Results. DFSP occurred most often in patients in their 30s (30%) and on the trunk (51.1%). Five patients (5.5%) experienced local recurrence during the 43.4-month follow-up period. Recurrence was found at a mean of 10.8 months after WLE. Although no factors were significantly associated with recurrence, recurrences were more frequent in head and neck. Recurrence-free survival was 87% in 6 years and 77% in 7 years.Conclusions. WLE with adequate lateral and deep margins can effectively control local recurrence rate and is a simple and effective method to treat DFSP.

scholarly journals Diagnostic Value of CT- and MRI-Based Texture Analysis and Imaging Findings for Grading Cartilaginous Tumors in Long Bones

2021 ◽  
Vol 11 ◽  
Author(s):  
Xue-Ying Deng ◽  
Hai-Yan Chen ◽  
Jie-Ni Yu ◽  
Xiu-Liang Zhu ◽  
Jie-Yu Chen ◽  
...  
Keyword(s):  
Texture Analysis ◽  
Feature Model ◽  
Imaging Feature ◽  
Low Grade ◽  
Long Bones ◽  
Imaging Features ◽  
High Grade ◽  
Accuracy Rate ◽  
Predictive Values ◽  
Cartilaginous Tumors

ObjectiveTo confirm the diagnostic performance of computed tomography (CT)-based texture analysis (CTTA) and magnetic resonance imaging (MRI)-based texture analysis for grading cartilaginous tumors in long bones and to compare these findings to radiological features.Materials and MethodsTwenty-nine patients with enchondromas, 20 with low-grade chondrosarcomas and 16 with high-grade chondrosarcomas were included retrospectively. Clinical and radiological information and 9 histogram features extracted from CT, T1WI, and T2WI were evaluated. Binary logistic regression analysis was performed to determine predictive factors for grading cartilaginous tumors and to establish diagnostic models. Another 26 patients were included to validate each model. Receiver operating characteristic (ROC) curves were generated, and accuracy rate, sensitivity, specificity and positive/negative predictive values (PPV/NPV) were calculated.ResultsOn imaging, endosteal scalloping, cortical destruction and calcification shape were predictive for grading cartilaginous tumors. For texture analysis, variance, mean, perc.01%, perc.10%, perc.99% and kurtosis were extracted after multivariate analysis. To differentiate benign cartilaginous tumors from low-grade chondrosarcomas, the imaging features model reached the highest accuracy rate (83.7%) and AUC (0.841), with a sensitivity of 75% and specificity of 93.1%. The CTTA feature model best distinguished low-grade and high-grade chondrosarcomas, with accuracies of 71.9%, and 80% in the training and validation groups, respectively; T1-TA and T2-TA could not distinguish them well. We found that the imaging feature model best differentiated benign and malignant cartilaginous tumors, with an accuracy rate of 89.2%, followed by the T1-TA feature model (80.4%).ConclusionsThe imaging feature model and CTTA- or MRI-based texture analysis have the potential to differentiate cartilaginous tumors in long bones by grade. MRI-based texture analysis failed to grade chondrosarcomas.

Resection Status Does Not Impact Recurrence in Well-Differentiated Liposarcoma of the Extremity

2021 ◽  
pp. 000313482110545
Author(s):  
Chelsea R. Olson ◽  
Lorena P. Suarez-Kelly ◽  
Cecilia G. Ethun ◽  
Rita D. Shelby ◽  
Peter Y. Yu ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Resection Margins ◽  
R0 Resection ◽  
Low Grade ◽  
Incomplete Resection ◽  
R1 Resection ◽  
Increased Risk ◽  
Clinicopathologic Factors ◽  
Resection Margin Status ◽  
Well Differentiated

Background Well-differentiated liposarcoma (WDLPS) is a low-grade soft tissue sarcoma with a propensity for local recurrence. The necessity of obtaining microscopically free surgical margins (R0) to minimize local recurrence is not clear. This study evaluates recurrence-free survival (RFS) of extremity WDLPS in relation to resection margin status. Methods A retrospective review of adult patients with primary extremity WDLPS at seven US institutions from 2000 to 2016 was performed. Patients with recurrent tumors or incomplete resection (R2) were excluded. Clinicopathologic factors were analyzed to assess impact on local RFS. Results 97 patients with primary extremity WDLPS were identified. The majority of patients had deep, lower extremity tumors. Mean tumor size was 18.2±8.9cm. Patients were treated with either radical (76.3%) or excisional (23.7%) resections; 64% had R0 and 36% had microscopically positive (R1) resection margins. Ten patients received radiation therapy with no difference in receipt of radiation between R0 vs R1 groups. Thirteen patients (13%) developed a local recurrence with no difference in RFS between R0 vs R1 resection. Five-year RFS was 59.5% for R0 vs 85.2% for R1. Only one patient died of disease after developing dedifferentiation and distant metastasis despite originally having an R0 resection. Discussion In this large multi-institutional study of surgical resection of extremity WDLPS, microscopically positive margins were not associated with an increased risk of recurrence. Positive microscopic margin resection for extremity WDLPS may yield similar rates of local control while avoiding a radical approach to obtain microscopically negative margins.

Mesenteric Fibromatosis in a Patient with Camurati-Engelmann Disease. A Case Report and Literature Review

2005 ◽  
Vol 91 (6) ◽  
pp. 552-554 ◽  
Author(s):  
Pierluigi Ballardini ◽  
Loretta Gulmini ◽  
Guido Margutti ◽  
Giorgio Lelli
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Rare Diseases ◽  
Bone Dysplasia ◽  
Low Grade ◽  
Long Bones ◽  
Rare Form ◽  
Rare Type ◽  
Mesenteric Fibromatosis ◽  
Engelmann Disease

Mesenteric fibromatosis is a rare type of desmoid tumor characterized by local aggressiveness and a tendency to relapse. In view of these characteristics it may be considered a low-grade fibrosarcoma. Camurati-Engelmann disease is a very rare form of bone dysplasia characterized by osteosclerosis of the diaphyses of the long bones. Here we describe the case of a male patient affected by these two rare diseases in association with chronic inflammatory intestinal disease.

Low-Grade Chondrosarcoma of Long Bones Treated with Intralesional Curettage Followed by Application of Phenol, Ethanol, and Bone-Grafting

2012 ◽  
Vol 94 (13) ◽  
pp. 1201-1207 ◽  
Author(s):  
Suzan H.M. Verdegaal ◽  
Hugo F.G. Brouwers ◽  
Erik W. van Zwet ◽  
Pancras C.W. Hogendoorn ◽  
Antonie H.M. Taminiau
Keyword(s):  
Bone Grafting ◽  
Low Grade ◽  
Long Bones ◽  
Intralesional Curettage

Low-Grade Fibromatosis-like Spindle Cell Carcinoma of the Breast

2015 ◽  
Vol 139 (4) ◽  
pp. 552-557 ◽  
Author(s):  
Jessica B. Dwyer ◽  
Beth Z. Clark
Keyword(s):  
Local Recurrence ◽  
Cell Carcinoma ◽  
Spindle Cell ◽  
Spindle Cell Carcinoma ◽  
Definitive Diagnosis ◽  
Low Grade ◽  
Carcinoma Of The Breast ◽  
Complete Excision ◽  
Favorable Prognosis ◽  
Spindle Cells

Low-grade fibromatosis-like spindle cell carcinoma is a rare tumor in the breast, and represents a variant of the very heterogeneous group of metaplastic carcinomas of the breast. These tumors warrant distinction because of their resemblance to pure fibromatosis, their propensity for local recurrence, and their favorable prognosis among the metaplastic carcinomas of the breast. The diagnosis is potentially challenging, particularly on core needle biopsies, because of the morphologic overlap with other low-grade spindle cell lesions. Recognition of a proliferation of cytologically bland spindle cells with areas of epithelial differentiation in combination with immunohistochemistry using antibodies against cytokeratins and myoepithelial markers should aid in producing a definitive diagnosis. These tumors can be locally aggressive with an increased incidence of local recurrence, but the potential for lymph node or distant metastasis is low. Complete excision with adequate margins is considered curative in the majority of cases.

Malignant Peripheral Nerve Sheath Tumors of the Head and Neck: Analysis of Prognostic Factors

2000 ◽  
Vol 122 (5) ◽  
pp. 667-672 ◽  
Author(s):  
Thom R. Loree ◽  
James H. North ◽  
Bruce A. Werness ◽  
Rina Nangia ◽  
Alan P. Mullins ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Peripheral Nerve ◽  
Head And Neck ◽  
Adjuvant Radiotherapy ◽  
Rank Test ◽  
Etiologic Factor ◽  
Low Grade ◽  
Nerve Sheath Tumors ◽  
Peripheral Nerve Sheath Tumors ◽  
Nerve Sheath

Malignant peripheral nerve sheath tumors of the head and neck region are uncommon and may be associated with neurofibromatosis or occur in a sporadic manner. This is a retrospective review of 17 patients with these tumors who were treated at a single institution. Analysis of clinical and pathologic factors that influenced outcome was performed. There were 9 men and 8 women. Seven patients had a history of neurofibromatosis. Radiotherapy was implicated as a possible etiologic factor in 4 patients. The neck was the most frequently involved site. Overall survival at 5 years was 52%. Survival was improved for women and for patients with low-grade tumors. Age, tumor site, and size had no impact on survival. Survival was worse for patients with neurofibromatosis than for those with the sporadic form of the disease ( P = 0.02). Survival was calculated by the method of Kaplan and Meier. The significance of such results was based on results of the log rank test. Local recurrence correlated with tumor size and resection margin status. No local recurrences occurred in those patients who had negative margins of resection and received adjuvant radiotherapy. Tumor grade was predictive of the development of distant metastases. Negative margins of resection are essential for obtaining local control, and the addition of adjuvant radiotherapy may be beneficial in this group. Salvage surgery for local recurrence is possible in some patients.

scholarly journals An Unusual Case of Clear Cell Chondrosarcoma with Very Late Recurrence and Lung Metastases, 29 Years after Primary Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Minna Laitinen ◽  
Jyrki Nieminen ◽  
Toni-Karri Pakarinen
Keyword(s):  
Local Recurrence ◽  
Clear Cell ◽  
Lung Metastases ◽  
Extended Period ◽  
Late Recurrence ◽  
Bone Neoplasm ◽  
Low Grade ◽  
Clear Cell Chondrosarcoma ◽  
Primary Surgery ◽  
Additional Surgery

Clear cell chondrosarcoma is a rare bone neoplasm with low-grade clinical course and the potential to metastasize to the skeleton and lungs. The aim of this report is to present a case that is extremely rare, but in accordance with the literature where the clear cell chondrosarcoma reportedly has a tendency for late metastases. In our patient the primary surgery was intralesional, since it was mistakenly interpreted as a benign tumour in the early 80s. The local recurrence and lung metastases occurred, however, 29 years after the initial treatment. The local recurrence was resected with wide margins, no additional surgery or oncological treatments were given, and two and half years postoperatively patient is doing well and there is no progression in the disease. In conclusion, it is important to have a long follow-up to the clear cell chondrosarcoma patients even for decades or lifelong, because the malignancy tends to metastasize or recur after an extended period. The course of metastasized disease may be unusually slow, so relatively aggressive treatment in metastasized and recurring cases is justified.

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