Sylvie Bonvalot1, Antonin Levy2,3,4, Philippe Terrier5, Dimitri Tzanis6, Sara Bellefqih2, Axel Le Cesne4,7, Cécile Le Péchoux2. 1. Department of Surgery, Institut Curie, PSL Research University, Paris, France. sylvie.bonvalot@curie.fr. 2. Department of Radiation Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France. 3. INSERM U1030, Molecular Radiotherapy, Gustave Roussy, Université Paris-Saclay, Villejuif, France. 4. Univ Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France. 5. Department of Pathology, Gustave-Roussy, Université Paris Sud, Villejuif, France. 6. Department of Surgery, Institut Curie, PSL Research University, Paris, France. 7. Department of Medical Oncology, Gustave-Roussy, Université Paris Sud, Villejuif, France.
Abstract
BACKGROUND: The objective of this study was to evaluate the adequate margin in the local treatment of extremity soft tissue sarcomas (ESTS) and understand the relationship between local control and overall survival (OS). METHODS: All consecutive patients treated for a primary ESTS at a single center from 1993 to 2012 were reviewed. RESULTS: In all, 531 patients were included. Twelve (2 %) underwent a first-line amputation. The resections were R0/R1/not available in 434 (82 %), 92 (17 %), and 5 patients (1 %). The median tumor size was 8 cm, and the tumor grades were 1 (n = 132), 2 (n = 201), and 3 (n = 195). The median size of the minimal margin was 2 mm on fixed specimen. Preop or postop chemotherapy was administered to 222 patients, and 414 received radiotherapy. With a median follow-up period of 7 years, the 5-year actuarial local recurrence (LR) rate and OS were 8 % (95 % CI, 6-11 %) and 80 % (95 % CI, 76-83 %). Predictors of worse OS were grade 3, leiomyosarcoma, male gender, and age >60 years, whereas tumor size, margin status, and LR were not. Among patients requiring re-excision (n = 252), the presence of residual cells correlated with OS but not LR. After preoperative treatment, a percentage of residual cells ≥10 % correlated with OS but not LR. In the multivariate analysis, specific subtypes (epithelioid sarcoma and myxofibrosarcoma) and margin size <1 mm correlated with LR, whereas grade and the tissue constituting the surgical margins did not. CONCLUSIONS: Specific subtypes and surgical margin size <1 mm were correlated with a higher LR. Neither the margin status nor LR affect OS.
BACKGROUND: The objective of this study was to evaluate the adequate margin in the local treatment of extremity soft tissue sarcomas (ESTS) and understand the relationship between local control and overall survival (OS). METHODS: All consecutive patients treated for a primary ESTS at a single center from 1993 to 2012 were reviewed. RESULTS: In all, 531 patients were included. Twelve (2 %) underwent a first-line amputation. The resections were R0/R1/not available in 434 (82 %), 92 (17 %), and 5 patients (1 %). The median tumor size was 8 cm, and the tumor grades were 1 (n = 132), 2 (n = 201), and 3 (n = 195). The median size of the minimal margin was 2 mm on fixed specimen. Preop or postop chemotherapy was administered to 222 patients, and 414 received radiotherapy. With a median follow-up period of 7 years, the 5-year actuarial local recurrence (LR) rate and OS were 8 % (95 % CI, 6-11 %) and 80 % (95 % CI, 76-83 %). Predictors of worse OS were grade 3, leiomyosarcoma, male gender, and age >60 years, whereas tumor size, margin status, and LR were not. Among patients requiring re-excision (n = 252), the presence of residual cells correlated with OS but not LR. After preoperative treatment, a percentage of residual cells ≥10 % correlated with OS but not LR. In the multivariate analysis, specific subtypes (epithelioid sarcoma and myxofibrosarcoma) and margin size <1 mm correlated with LR, whereas grade and the tissue constituting the surgical margins did not. CONCLUSIONS: Specific subtypes and surgical margin size <1 mm were correlated with a higher LR. Neither the margin status nor LR affect OS.
Authors: Juan Pablo Zumárraga; Felipe Augusto Ribeiro Batista; André Mathias Baptista; Marcelo Tadeu Caiero; Luis Pablo de la Rosa Martino; Olavo Pires de Camargo Journal: Acta Ortop Bras Date: 2018 Impact factor: 0.513
Authors: Florian Posch; Richard Partl; Carmen Döller; Jakob M Riedl; Maria Smolle; Lukas Leitner; Marko Bergovec; Bernadette Liegl-Atzwanger; Michael Stotz; Angelika Bezan; Armin Gerger; Martin Pichler; Karin S Kapp; Herbert Stöger; Andreas Leithner; Joanna Szkandera Journal: Ann Surg Oncol Date: 2017-09-11 Impact factor: 5.344
Authors: Rémi Bourdais; Samir Achkar; Charles Honoré; Matthieu Faron; Andrea Cavalcanti; Guillaume Auzac; Carine Ngo; Leila Haddag-Miliani; Benjamin Verret; Sarah Dumont; Eric Deutsch; Axel Le Cesne; Olivier Mir; Cécile Le Péchoux; Antonin Levy Journal: Clin Transl Radiat Oncol Date: 2021-06-04