Margin Assessment in Soft Tissue Sarcomas: Review of the Literature

Adequacy of margins must take into consideration both the resection margin width (quantity) and anatomic barrier (quality). There are several classification schemes for reporting surgical resection margin status for soft tissue sarcomas (STS). Most of the studies regarding treatment outcomes in STS included all histologic grades and histological subtypes, which include infiltrative and non-infiltrative subtypes and are very heterogeneous in terms of both histologic characteristics and treatment modalities (adjuvant treatments or not). This lack of consistency makes it difficult to compare results from study to study. Therefore, there is a great need for evidence-based standardization concerning the width of resection margins. The aim of this narrative review is to provide a comprehensive assessment of the literature on margins, and to highlight the need for a uniform description of the margin status for patients with STS. Patient cases should be discussed at multidisciplinary tumor boards and treatments should be individualized to clinical and demographic characteristics, which must include also a deep knowledge of specific histotypes behaviors, particularly infiltrative ones.

Meta-analysis of prognostic factors for recurrence of resected well-differentiated pancreatic neuroendocrine tumors

Well-differentiated pancreatic neuroendocrine tumors (WDPNETs) are a group of rare and heterogeneous tumors. However, the prognostic factors for recurrence after curative resection still remain controversial. We aim to illustrate the prognostic factors for recurrence of resected WDPNETs. All relevant articles published through June 2020 were identified via PubMed, Embase, Web of Science and the Cochrane Library. Articles that examined the prognostic factors of WDPNETs were enrolled. 10 articles were finally included in this study. From 1993 to 2018, 2863 patients underwent curative resection and 358 patients had recurrence, the combined recurrence rate was 13%. Furthermore, the pooled data indicated that patients with G2, positive lymph node and surgical resection margin, vascular invasion and perineural invasion had a decreased disease free survival for WDPNETs. However, gender, function, and tumor size had no significant relationship with WDPNETs recurrence. These findings demonstrated that G2, positive lymph node and surgical resection margin, vascular invasion and perineural invasion could be prognostic factors for recurrence of resected WDPNETs, indicating that patients with these high-risk factors need closer postoperative follow-up, and may benefit from adjuvant therapy.