Optimal surgical margin for infiltrative soft tissue sarcomas: Assessing the efficacy of excising beyond the infiltration
Background Tumor infiltration in soft tissue sarcoma (STS) is known to correlate with an inadequate surgical margin and poor local control. This study aims to determine whether the radiological infiltration (R‐inf) in STS cor relates with histological infiltration (H‐inf) and to devise methods to de...
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| Veröffentlicht in: | Journal of surgical oncology 2018-09, Vol.118 (3), p.525-531 |
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| container_title | Journal of surgical oncology |
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| creator | Iwata, Shintaro Araki, Akinobu Funatsu, Hiroyuki Yonemoto, Tsukasa Kamoda, Hiroto Itami, Makiko Ishii, Takeshi |
| description | Background
Tumor infiltration in soft tissue sarcoma (STS) is known to correlate with an inadequate surgical margin and poor local control. This study aims to determine whether the radiological infiltration (R‐inf) in STS cor relates with histological infiltration (H‐inf) and to devise methods to determine a resection margin for infiltrative STS.
Methods
We reviewed the medical records of 145 patients with high‐grade STS. We measured the R‐inf on short‐T1 inversion recovery or gadolinium‐enhanced fat‐suppressed (GdFS) magnetic resonance imaging. In addition, we assessed H‐inf as the infiltrative growth of atypical tumor cells. The local control rate (LCR) was assessed using the Kaplan‐Meier method.
Results
A statistically significant positive correlation was found between H‐inf and R‐inf (P |
| doi_str_mv | 10.1002/jso.25165 |
| format | Article |
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Tumor infiltration in soft tissue sarcoma (STS) is known to correlate with an inadequate surgical margin and poor local control. This study aims to determine whether the radiological infiltration (R‐inf) in STS cor relates with histological infiltration (H‐inf) and to devise methods to determine a resection margin for infiltrative STS.
Methods
We reviewed the medical records of 145 patients with high‐grade STS. We measured the R‐inf on short‐T1 inversion recovery or gadolinium‐enhanced fat‐suppressed (GdFS) magnetic resonance imaging. In addition, we assessed H‐inf as the infiltrative growth of atypical tumor cells. The local control rate (LCR) was assessed using the Kaplan‐Meier method.
Results
A statistically significant positive correlation was found between H‐inf and R‐inf (P < 0.0001). The R‐inf obtained from the GdFS images exhibited a stronger correlation with H‐inf than that obtained from the short‐T1 inversion recovery images. Univariate and multivariate analyses revealed that a positive H‐inf significantly correlated with a poor LCR. Moreover, the contaminated margins, which included intrainfiltration margins, significantly correlated with a poor LCR compared with the wide margins.
Conclusions
R‐inf as assessed by the GdFS images significantly correlates with H‐inf, suggesting that we should exercise the infiltrative STS beyond their R‐infs detected by the GdFS images.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.25165</identifier><identifier>PMID: 30259517</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cancer surgery ; Female ; Follow-Up Studies ; Humans ; local recurrence ; Male ; Margins of Excision ; Middle Aged ; Prognosis ; Retrospective Studies ; Sarcoma ; Sarcoma - pathology ; Sarcoma - surgery ; soft tissue sarcoma (STS) ; surgery ; Surgical outcomes ; Surgical Procedures, Operative - standards ; Survival Rate ; tumor infiltration ; Tumors ; Young Adult</subject><ispartof>Journal of surgical oncology, 2018-09, Vol.118 (3), p.525-531</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4195-470e0e39adb2f85b95b82f0cc25b0c34d8bf9b0dea2c89ceeb17784e046c07a83</citedby><cites>FETCH-LOGICAL-c4195-470e0e39adb2f85b95b82f0cc25b0c34d8bf9b0dea2c89ceeb17784e046c07a83</cites><orcidid>0000-0002-2024-514X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjso.25165$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.25165$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30259517$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iwata, Shintaro</creatorcontrib><creatorcontrib>Araki, Akinobu</creatorcontrib><creatorcontrib>Funatsu, Hiroyuki</creatorcontrib><creatorcontrib>Yonemoto, Tsukasa</creatorcontrib><creatorcontrib>Kamoda, Hiroto</creatorcontrib><creatorcontrib>Itami, Makiko</creatorcontrib><creatorcontrib>Ishii, Takeshi</creatorcontrib><title>Optimal surgical margin for infiltrative soft tissue sarcomas: Assessing the efficacy of excising beyond the infiltration</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Background
Tumor infiltration in soft tissue sarcoma (STS) is known to correlate with an inadequate surgical margin and poor local control. This study aims to determine whether the radiological infiltration (R‐inf) in STS cor relates with histological infiltration (H‐inf) and to devise methods to determine a resection margin for infiltrative STS.
Methods
We reviewed the medical records of 145 patients with high‐grade STS. We measured the R‐inf on short‐T1 inversion recovery or gadolinium‐enhanced fat‐suppressed (GdFS) magnetic resonance imaging. In addition, we assessed H‐inf as the infiltrative growth of atypical tumor cells. The local control rate (LCR) was assessed using the Kaplan‐Meier method.
Results
A statistically significant positive correlation was found between H‐inf and R‐inf (P < 0.0001). The R‐inf obtained from the GdFS images exhibited a stronger correlation with H‐inf than that obtained from the short‐T1 inversion recovery images. Univariate and multivariate analyses revealed that a positive H‐inf significantly correlated with a poor LCR. Moreover, the contaminated margins, which included intrainfiltration margins, significantly correlated with a poor LCR compared with the wide margins.
Conclusions
R‐inf as assessed by the GdFS images significantly correlates with H‐inf, suggesting that we should exercise the infiltrative STS beyond their R‐infs detected by the GdFS images.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>local recurrence</subject><subject>Male</subject><subject>Margins of Excision</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Sarcoma</subject><subject>Sarcoma - pathology</subject><subject>Sarcoma - surgery</subject><subject>soft tissue sarcoma (STS)</subject><subject>surgery</subject><subject>Surgical outcomes</subject><subject>Surgical Procedures, Operative - standards</subject><subject>Survival Rate</subject><subject>tumor infiltration</subject><subject>Tumors</subject><subject>Young Adult</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtr3DAUhUVoaSZpF_kDRdBNu5jkSn6quxDaPAjMou3aSPJVqsG2prp2Wv_7aGbygEBXOnA-Pi46jJ0IOBUA8mxN4VQWoiwO2EKAKpcKVP2GLVInl3ml4JAdEa0BQKkyf8cOM5CFKkS1YPNqM_ped5ymeOdtCr1OYeAuRO4H57sx6tHfI6fgRj56oillHW3oNX3l50RI5Ic7Pv5Gjs4lh515cBz_Wb8rDM5haHf9izAM79lbpzvCD4_vMfv1_dvPi6vl7ery-uL8dmlzoYp0PiBgpnRrpKsLowpTSwfWysKAzfK2Nk4ZaFFLWyuLaERV1TlCXlqodJ0ds8977yaGPxPS2PSeLHadHjBM1EghMlmWQm3RT6_QdZjikK7bUjKvqlLlifqyp2wMRBFds4npC-PcCGi2ezRpj2a3R2I_Phon02P7TD4NkICzPfDXdzj_39Tc_FjtlQ9ppZa3</recordid><startdate>20180901</startdate><enddate>20180901</enddate><creator>Iwata, Shintaro</creator><creator>Araki, Akinobu</creator><creator>Funatsu, Hiroyuki</creator><creator>Yonemoto, Tsukasa</creator><creator>Kamoda, Hiroto</creator><creator>Itami, Makiko</creator><creator>Ishii, Takeshi</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2024-514X</orcidid></search><sort><creationdate>20180901</creationdate><title>Optimal surgical margin for infiltrative soft tissue sarcomas: Assessing the efficacy of excising beyond the infiltration</title><author>Iwata, Shintaro ; Araki, Akinobu ; Funatsu, Hiroyuki ; Yonemoto, Tsukasa ; Kamoda, Hiroto ; Itami, Makiko ; Ishii, Takeshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4195-470e0e39adb2f85b95b82f0cc25b0c34d8bf9b0dea2c89ceeb17784e046c07a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>local recurrence</topic><topic>Male</topic><topic>Margins of Excision</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Sarcoma</topic><topic>Sarcoma - pathology</topic><topic>Sarcoma - surgery</topic><topic>soft tissue sarcoma (STS)</topic><topic>surgery</topic><topic>Surgical outcomes</topic><topic>Surgical Procedures, Operative - standards</topic><topic>Survival Rate</topic><topic>tumor infiltration</topic><topic>Tumors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iwata, Shintaro</creatorcontrib><creatorcontrib>Araki, Akinobu</creatorcontrib><creatorcontrib>Funatsu, Hiroyuki</creatorcontrib><creatorcontrib>Yonemoto, Tsukasa</creatorcontrib><creatorcontrib>Kamoda, Hiroto</creatorcontrib><creatorcontrib>Itami, Makiko</creatorcontrib><creatorcontrib>Ishii, Takeshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iwata, Shintaro</au><au>Araki, Akinobu</au><au>Funatsu, Hiroyuki</au><au>Yonemoto, Tsukasa</au><au>Kamoda, Hiroto</au><au>Itami, Makiko</au><au>Ishii, Takeshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal surgical margin for infiltrative soft tissue sarcomas: Assessing the efficacy of excising beyond the infiltration</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>118</volume><issue>3</issue><spage>525</spage><epage>531</epage><pages>525-531</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background
Tumor infiltration in soft tissue sarcoma (STS) is known to correlate with an inadequate surgical margin and poor local control. This study aims to determine whether the radiological infiltration (R‐inf) in STS cor relates with histological infiltration (H‐inf) and to devise methods to determine a resection margin for infiltrative STS.
Methods
We reviewed the medical records of 145 patients with high‐grade STS. We measured the R‐inf on short‐T1 inversion recovery or gadolinium‐enhanced fat‐suppressed (GdFS) magnetic resonance imaging. In addition, we assessed H‐inf as the infiltrative growth of atypical tumor cells. The local control rate (LCR) was assessed using the Kaplan‐Meier method.
Results
A statistically significant positive correlation was found between H‐inf and R‐inf (P < 0.0001). The R‐inf obtained from the GdFS images exhibited a stronger correlation with H‐inf than that obtained from the short‐T1 inversion recovery images. Univariate and multivariate analyses revealed that a positive H‐inf significantly correlated with a poor LCR. Moreover, the contaminated margins, which included intrainfiltration margins, significantly correlated with a poor LCR compared with the wide margins.
Conclusions
R‐inf as assessed by the GdFS images significantly correlates with H‐inf, suggesting that we should exercise the infiltrative STS beyond their R‐infs detected by the GdFS images.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30259517</pmid><doi>10.1002/jso.25165</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2024-514X</orcidid></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Cancer surgery Female Follow-Up Studies Humans local recurrence Male Margins of Excision Middle Aged Prognosis Retrospective Studies Sarcoma Sarcoma - pathology Sarcoma - surgery soft tissue sarcoma (STS) surgery Surgical outcomes Surgical Procedures, Operative - standards Survival Rate tumor infiltration Tumors Young Adult |
| title | Optimal surgical margin for infiltrative soft tissue sarcomas: Assessing the efficacy of excising beyond the infiltration |
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