Sarcomas of the Nasal Cavity and Paranasal Sinuses

1994 ◽  
Vol 103 (9) ◽  
pp. 699-704 ◽  
Author(s):  
Joel A. Sercarz ◽  
Rufus J. Mark ◽  
Ian Storper ◽  
Luu Tran ◽  
Thomas C. Calcaterra
Keyword(s):  
Los Angeles ◽  
Paranasal Sinuses ◽  
Adjuvant Radiotherapy ◽  
Combined Modality Therapy ◽  
Surgical Margin ◽  
Surgical Margins ◽  
Low Grade ◽  
Positive Surgical Margins ◽  
Key Issues ◽  
The University

Sarcomas of the nose and paranasal sinuses are rare malignancies. Key issues remain unresolved in the management of these tumors, particularly with regard to the role of radiotherapy. To help clarify these issues, 48 consecutive cases of nasal and paranasal sinus sarcomas treated at the University of California, Los Angeles, between 1958 and 1988 were retrospectively reviewed. Six of 16 patients managed initially with surgery alone were cured. All had negative surgical margins and 5 of the 6 had low-grade tumors. Of 5 patients with high-grade lesions treated with surgery only, 1 was rendered free of disease. Twelve patients with positive surgical margins were treated with adjuvant radiotherapy; 5 were cured with this approach. Grade and surgical margin status were found to be significantly related to outcome for sinonasal sarcoma. There were 14 patients with rhabdomyosarcoma; 3 were cured with modern combined-modality therapy. Patients with positive surgical margins should be treated with adjuvant radiotherapy. Surgical therapy is effective for low-grade lesions that are completely excised.

scholarly journals Oncological Outcomes of Transoral Laryngeal Microsurgery with Fiber-Optic Diode Laser for Early Glottic Cancer: A Single-Center Experience

2021 ◽  
pp. 1-13
Author(s):  
Mehmet Hakan Korkmaz ◽  
Ömer Bayır ◽  
Esra Bozkurt Hatipoğlu ◽  
Emel Çadalli Tatar ◽  
Ünsal Han ◽  
...  
Keyword(s):  
Early Stage ◽  
Anterior Commissure ◽  
Survival Rates ◽  
Surgical Margin ◽  
Surgical Margins ◽  
Positive Surgical Margin ◽  
Single Center ◽  
Positive Surgical Margins ◽  
Histopathological Grade ◽  
T Stage

<b><i>Backgroud/Objectives:</i></b> Transoral laser laryngeal microsurgery (<sub>L</sub>TLM) has been widely used in the treatment of early-stage glottic laryngeal squamous cell carcinoma (LSCC) for the past few decades. Although T stage, tumor grade, anterior commissure involvement, type of cordectomy, positive surgical margin, and postoperative additional therapies were accused as the prognostic factors for recurrence, there is still controversy about these data in the literature. The purpose of this study was to evaluate the oncological results of our patients with early glottic LSCC treated with <sub>L</sub>TLM as a single-modality therapy in a single-center study. <b><i>Methods:</i></b> Patients with early-stage (T<sub>is-1–2</sub>/N<sub>0</sub>) glottic LSCC who underwent <sub>L</sub>TLM as a primary treatment from 2011 to 2019 were retrospectively reviewed. The clinicopathological factors and oncologic outcomes were analyzed. <b><i>Results:</i></b> One hundred and sixty-one patients were enrolled in this study. The 5-year overall (OS), disease-specific (DSS), disease-free (DFS), and laryngectomy-free survival rates were 84.5%, 97.9%, 79.2%, and 93.5%, respectively. The most common stage, histopathological type, and type of endoscopic cordectomy were T<sub>1</sub> stage, well-differentiated cancer, and type 2 cordectomy, respectively. A positive surgical margin was defined in 20 (12.4%) patients. There was a significant relationship between histopathological grade and positive surgical margins (<i>p</i> = 0.038). OS and DSS rates of “wait and see” modality were lower, while DFS of radiotherapy was lower than that of other treatment modalities in patients with positive surgical margins, but the differences were not statistically significant. Nineteen (11.8%) patients had a recurrence. DSS was statistically significantly lower in patients with recurrence (<i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> The results of our study showed that anterior commissure involvement, surgical margin positivity, and higher T stage statistically did not reduce survival rates in early-stage LSCC patients treated with <sub>L</sub>TLM. As the histopathological grade of the tumor worsens, the risk of surgical margin positivity increases. RT may have a negative effect on recurrence and organ preservation in the additional treatment of patient with positive surgical margins.

scholarly journals Aggressive Angiomyxoma: A Rare Perineal Mass

2019 ◽  
Vol 3 (3) ◽  
pp. 172
Author(s):  
Mehmet Sait Ozsoy ◽  
Nuray Colapkulu ◽  
Aman Gapbarov ◽  
Ozgur Ekinci ◽  
Nesrin Gunduz ◽  
...  
Keyword(s):  
Gold Standard ◽  
Immunohistochemical Staining ◽  
Surgical Margin ◽  
Surgical Margins ◽  
Time Range ◽  
Aggressive Angiomyxoma ◽  
Rare Tumour ◽  
Positive Surgical Margins ◽  
S 100 ◽  
History Of

Aggressive angiomyxoma (AAM) is a rare tumour that usually occurs in females at reproductive ages and affects pelvic region. We herein report a case of perineal AAM to conribute to the literature about pathological features and clinical outcomes of this tumour. A 36 year old female with no history of chronic diseases presented to our hospital with a nontender perineal mass. The mass was present for two years and it first appeared during pregnancy. She underwent surgery for local resection. The histology of the mass was consistent with AAM and multifocal extention into surgical margins was observed. With immunohistochemical staining the tumor was positive for desmin, CD31, CD34, ER and PR; poorly focal positive for SMA and negative for S-100. Ki67 was less than 1%. Due to surgical margin positivity she had a second operation. After the resection with clear margins, patient showed no signs of reccurence for 7 months. Resections with positive surgical margins were mostly concluded as reccurent with wide time range and reccurence rates, extended surgical resection is gold standard for management of this tumour.International Journal of Human and Health Sciences Vol. 03 No. 03 July’19. Page: 172-174

scholarly journals Reflector Localization of Breast Lesions and Parameters Associated with Positive Surgical Margins in Women Undergoing Breast Conservation Surgery

2020 ◽  
Vol 2 (5) ◽  
pp. 462-470
Author(s):  
Cherie M Kuzmiak ◽  
Suk Jung Kim ◽  
Sheila S Lee ◽  
Sheryl G Jordan ◽  
Kristalyn K Gallagher ◽  
...  
Keyword(s):  
Breast Conservation ◽  
Surgical Margin ◽  
Surgical Margins ◽  
Breast Conservation Surgery ◽  
Positive Surgical Margin ◽  
Breast Lesions ◽  
Positive Surgical Margins ◽  
Final Pathology ◽  
Lesion Type ◽  
Malignant Diagnosis

Abstract Objective To evaluate our experience with reflector localization of breast lesions and parameters influencing surgical margins in patients with a malignant diagnosis. Methods A retrospective institution review board–approved review of our institutional database was performed for breast lesions preoperatively localized from September 1, 2016, through December 31, 2017. Wire localizations were excluded. From electronic medical records and imaging, the following data was recorded: breast density, lesion type and size, reflector placement modality and number placed, reflector distance from lesion and skin, excision of lesion and reflector, tissue volume, margin status, and final pathology. Statistical analysis was performed with a Fisher’s exact test, Mann-Whitney test, and logistic regression. P &lt; 0.05 was significant. Results A total of 111 reflectors were deployed in the breasts of 103 women with 109 breast lesions. Ninety (81.1%) reflectors were placed under mammographic guidance and 21 (18.9%) under US. The lesions consisted of 68 (62.4%) masses, 17 (15.6%) calcifications, 2 (1.8%) architectural distortions, and 22 (20.2%) biopsy markers. Fourteen (21.2%) of 66 cases with a preoperative malignant diagnosis had a positive surgical margin. Final pathology, including 6 lesions upgraded to malignancy on excision, demonstrated 72 (66.0%) malignant, 22 (20.2%) high-risk, and 15 (13.8%) benign lesions. Univariate and multivariate analysis revealed no statistically significant parameters (lesion type or size, placement modality, reflector distance to skin or lesion, specimen radiography or pathology) were associated with a positive surgical margin. Conclusion Reflector localization is an alternative to wire localization of breast lesions. There were no lesion-specific or technical parameters affecting positive surgical margins.

scholarly journals Research Progress Regarding Surgical Margins, Molecular Margins, and Prognosis of Laryngeal Carcinoma

2020 ◽  
pp. 014556132090314 ◽  
Author(s):  
Ye Beibei ◽  
Yang Rong ◽  
Yan Yunfei ◽  
Zhang Wenchao
Keyword(s):  
Laryngeal Carcinoma ◽  
Malignant Tumors ◽  
Surgical Margin ◽  
Clinical Intervention ◽  
Molecular Biomarkers ◽  
Surgical Margins ◽  
Research Progress ◽  
Laryngeal Function ◽  
Altered Expression ◽  
Positive Surgical Margins

Background: Laryngeal carcinoma is one of the most common malignant tumors of the head and neck. Researchers have refined the study of surgical margin in the anatomical subarea of the larynx to determine the most appropriate distance of the surgical margin for laryngeal carcinoma, to achieve accurate resection of laryngeal carcinoma and to improve the possibility of retention of laryngeal function. Methods: A comprehensive review of the primary literature was performed from 2009 to 2019 utilizing keywords laryngeal carcinoma, surgical margin, molecular margin, and prognostic factor. Articles were included at the discretion of the authors based on novel and/or contributions to the literature. Results: The prognosis of laryngeal carcinoma significantly correlates with the status of surgical margins. Patients with positive surgical margins have higher recurrence and metastasis rates and worse prognosis. Patients with negative pathological surgical margin but with the expression or altered expression levels of one or more tumor-related molecular biomarkers had high rates of recurrence and metastasis, and poor prognosis. Conclusions: Clinical intervention can improve the prognosis of patients with positive surgical margins. Patients with close margins should be followed closely. Among patients with negative surgical margins, patients with abnormal molecular margin results should be closely followed up. However, the specific selection of one or several molecular biomarkers as the detection index of molecular margin currently requires multicenter prospective or retrospective large sample study as guidance.

Defining pathological variables to predict biochemical failure in patients with positive surgical margins at radical prostatectomy: implications for adjuvant radiotherapy

2009 ◽  
Vol 105 (10) ◽  
pp. 1377-1380 ◽  
Author(s):  
Matthew J. Resnick ◽  
Daniel J. Canter ◽  
Thomas J. Guzzo ◽  
Laurie Magerfleisch ◽  
John E. Tomaszewski ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Adjuvant Radiotherapy ◽  
Biochemical Failure ◽  
Surgical Margins ◽  
Positive Surgical Margins

scholarly journals Dermatofibrosarcoma Protuberans and Adjuvant Radiotherapy: A Case Report with Uncertain Surgical Margins in The Breast

2021 ◽  
pp. 342-349
Author(s):  
Alaettin Arslan ◽  
Saliha Karagoz Eren ◽  
Serdal Sadet Ozcan ◽  
Ebru Akay ◽  
Mustafa Ozdemir
Keyword(s):  
Adjuvant Radiotherapy ◽  
Surgical Margin ◽  
Dermatofibrosarcoma Protuberans ◽  
Residual Tumor ◽  
Primary Treatment ◽  
The Body ◽  
Surgical Margins ◽  
Pathology Report ◽  
Tumor Diameter ◽  
Margin Of Safety

Background: Dermatofibrosarcoma Protuberans (DFSP) is a rare, locally aggressive superficial soft tissue tumor that can occur in many parts of the body. Surgical resection with a wide margin of safety is the main treatment modality of this rare tumor of the breast. According to the postoperative pathology report, the patient can be followed up or adjuvant radiotherapy (RT) can be added.  Case presentation: A 22-year-old woman presented with a mass filling the lower inner quadrant of her right breast. Tru-cut biopsy revealed a mesenchymal tumor, but excision was recommended for definitive diagnosis. A right breast quadrantectomy was performed. The result came as DFSP. Tumor diameter was 10x9x6.5 cm and the tumor was positive in most of the surgical margins. The patient underwent re-resection and a residual tumor with a diameter of 0.2 cm was detected at a distance of 3.3 cm from the surgical margin. Although the surgical margins were negative, the distance of the posterior surgical margin, in particular, could not be assured. Because of the uncertainty of surgical margins, 60 Gy RT was planned. Conclusion: The localization of DFSP in the breast is extremely rare and surgery is the primary treatment. RT should be added as an adjuvant when safe surgical margins cannot be obtained.

Correlation of biologic recurrence after radical prostatectomy and a positive surgical margin with the predominant Gleason pattern on the specimen.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15145-e15145
Author(s):  
Yann Neuzillet ◽  
Audrey Pichon ◽  
Thierry Lebret ◽  
Jean-Pierre Raynaud ◽  
Henry Botto
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Surgical Margin ◽  
Surgical Margins ◽  
Rank Test ◽  
Multivariate Logistic Regression Model ◽  
Positive Surgical Margin ◽  
Positive Surgical Margins ◽  
Gleason Pattern

e15145 Background: The risk of biological recurrence following radical prostatectomy depends, among other factors, on surgical margins status. This study compared the prognosis of prostate cancer patients with positive surgical margins according to the predominant Gleason pattern (PrdGP). Methods: Prospective study of 247 consecutive prostate cancer patients, who underwent radical prostatectomy (RP) from 3/2007 to 12/2009, and were followed up in our institution. Pathological stage and Gleason score were determined in RP specimens by a pathological reference. Biological recurrence was defined as two consecutive values of PSA > 0.2 ng/mL. The median overall follow-up was 33 months (2 to 54 months). Biological recurrence-free survival was estimated and compared using Kaplan-Meier plots and Log rank test. A multivariate logistic regression model was done with PrdGP4, and two other predictive variables (pT≥3a, preoperative PSA level) entered as statistically significant independent predictors of biological recurrence. Results: Forty-eight patients (19.4%) had a positive surgical margins, 26 patients have PrdGP3 (54%) and 22 have PrdGP4 (46%). Whereas 7 biological recurrences were observed in PrdGP4 patients, none occurred in PrdGP3 patients. Biological recurrence-free survivals were significantly different (Log rank p=0.001). In multivariate analysis, PrdGP4 was a predictor of biological recurrence (p<0.0001, OR= 9.023, 95% CI [3.161–25.757]). Conclusions: This study demonstrates that biological recurrence after positive surgical margin are correlated with the predominant Gleason pattern assessed on radical prostatectomy specimen which s more easily evaluable than accurate margins features. Adjuvant treatment, specifically external beam radiotherapy, should be indicated in accordance to this result. [Table: see text]

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